非穿透小梁切除联合羊膜植入治疗原发性开角型青光眼

Nonperforating trabecular surgery combined with amniotic membrane transplantation for the treatment of primary open angle glaucoma

摘要:

目的：评估非穿透小梁切除术联合丝裂霉素处理的羊膜植入术治疗原发性开角型青光眼的临床疗效。 方法：原发性开角型青光眼患者40例58眼行非穿透小梁切除术联合丝裂霉素处理的羊膜植入术，术后进行6~18mo随访，对患者的眼压、视力以及滤过泡情况进行观察。 结果：手术后患者的眼压控制良好，术后的视力与术前比较没有显著的变化，而术后18mo的平均眼压（17.6±45mmHg）和术前的平均眼压（35.3±6.8mmHg）对比，差异有统计学意义（t=16.531，P<0.05）。在随访期间有27眼（46.55%）患者有功能性滤过泡，需用药物治疗者5眼。9眼（15.52%）患者滤过泡有苍白局限化，表现出贫血状。 结论：非穿透小梁切除术联合丝裂霉素处理的羊膜植入术治疗原发性开角型青光眼可以有效地降低眼压，临床疗效良好。

Abstract:

AIM:To evaluate the clinical effect of nonperforating trabecular surgery (NPTS) combined with amniotic membrane implantation processed with mitomycin for the treatment of primary open angle glaucoma(POAG). METHODS:Fourty cases (58 eyes) with POAG executed NPTS with amniotic membrane implantation processed with mitomycin. Visual acuity, intraocular pressure and the type of blebs were recorded. RESULTS:The intraocular pressure is good after the surgery, there was no statistically significant difference in the visual acuity. The preoperative intraocular pressure was 35.3±6.8mmHg, but postoperative was 17.6±45mmHg, the difference was significant （t=16.531，P<005）. During the visit, 27 eyes （46.55%） had functional blebs, 5 eyes treated with medicine. 9 eyes（15.52%） had blebs with etiolation and presented anemia. CONCLUSION: NPTS with amniotic membrane implantation processed with mitomycin is good for the treatment of POAG.