羊膜用于青光眼滤过术的临床研究  

A randomized control clinical trial of glaucoma filtering surgery with amniotic membrane

作　　者：李盈龙[1] 刘钢生[1] 赵军民[1] 徐新华[1] 

机构地区：[1]安徽省合肥市第一人民医院眼科,230061

出　　处：《临床眼科杂志》2003年第3期213-215,共3页Journal of Clinical Ophthalmology

摘　　要：目的　研究保存羊膜在青光眼滤过术中的抗增生作用。方法　采用随机对照临床实验方法 ,施行统一的小梁切除术 ,将 68例 (78只眼 )确诊的青光眼分为移植组 41只眼和对照组 3 7只眼。移植组术中在巩膜瓣下植入羊膜移植片 ,对照组术中巩膜瓣下未植入羊膜移植术。术后随访观察 8个月～ 3年 ,采用寿命表方法统计。结果　眼压 :移植组和对照组平均眼压分别由术前 (3 6.72± 10 .70 ) mm Hg(1mm Hg=0 .13 3 k Pa)、(3 5 .3 7± 8.94) mm Hg,降至术后 (16.45± 3 .87) mm Hg、(2 0 .46± 3 .0 9) m m Hg,两组间差异有显著意义 (P <0 .0 1) ;滤过泡 :移植组和对照组功能性滤过泡的累计生存率分别为 82 .86%和 42 .64 % ,两组间差异有显著意义 (P <0 .0 1) ;手术成功率 :移植组和对照组手术成功率分别为 82 .5 6%、42 .87% ,两组间差异有显著意义 (P <0 .0 1) ;视力 :移植组术后视力好于对照组 (P <0 .0 1) ;并发症 :移植组和对照组差异无显著意义 (P >0 .5 )。结论　羊膜移植可减少滤过道疤痕的形成 ,显著提高青光眼滤过术的成功率 。Objective To study the antiproliferative effects of preserved amniotic membrane on glaucoma filtering surgery.Methods In a randomized control clinical trial 68 patients (78 eyes) with glaucoma underwent trabeculectomy with and without amniotic membrane.In the amniotic membrane transplanted group (41 eyes),amniotic membrane was implanted under the scleral flap intraoperative.In the control group (37 eyes),amniotic membrane was not used.The follow-up period was 8 months to 3 years,and the data were analysed by using the Life-table method.Results The mean intraocular pressure (IOP) in the transplanted group reduce from (36.72±10.70)mmHg (1mmHg=0.133kPa) to (16.45±3.87)mmHg and that in the control group reduce from (35.37±8.94)mmHg to (20.46±3.09)mmHg,the difference being significant(P<0.01).The cumulative exiting rate of functioning bleb in the transplanted group was 82.86% and that in the control group was 42.64%,the difference being significant (P<0.01).The cumulative success probability in the transplanted group was 82.56% and that in the control group was 42.87%,the difference being significant (P<0.01).The increasing of postoperative visual acuity in the transplanted group was significantly greater than that in to control group (P<0.01).There was no significant change in complications between the transplanted group and the control group (P>0.5).Conclusion The study indicates that amniotic membrane transplantation can effectively inhibit the scar formation,low down the IOP to a target level,increase the success rate considerably.The method is safe and effective in the management of glaucoma.

关 键 词：羊膜移植 青光眼 滤过术 抗增生作用 实验 小梁切除术 成纤维细胞增生 

分 类 号：R779.6[医药卫生—眼科]