复合式与单纯小梁切除术治疗青光眼的疗效

Comparison of efficacy of compound and simple trabeculectomy for glaucoma

摘要:

目的：对比观察复合式与单纯小梁切除术治疗青光眼的临床疗效。

方法：青光眼患者73例82眼随机分为A组(37例42眼)和B组(36例40眼)，分别采用复合式小梁切除术和单纯小梁切除术治疗，术后随访3mo，观察并比较两组的浅前房发生率、滤过泡形成情况以及眼压控制情况。

结果：A组浅前房发生率为4.8%(Ⅰ度)，B组浅前房发生率为35.0%(Ⅰ度+Ⅱ度)，两组浅前房发生率比较，差异有统计学意义(P<0.05)； A组随访结束时共38眼(90.5%)为功能性滤过泡，B组共28眼(70.0%)为功能性滤过泡，两组功能性滤过泡形成率比较，差异有统计学意义(P<0.05)； 术后3mo时，A组眼压获完全控制者共37眼(88.1%)，显著高于B组(52.5%)，组间比较差异有统计学意义(P<0.05)； 术后3mo时，A组平均眼压为15.2±2.3mmHg，显著低于B组(18.5±2.5mmHg)，组间比较差异有统计学意义(P<0.05)。

结论：复合式小梁切除术可有效减少术后浅前房的发生，在功能性滤过泡形成和眼压控制方面疗效显著，明显优于单纯小梁切除术。

Abstract:

AIM: To compare the clinical efficacy of compound and simple trabeculectomy for glaucoma.

METHODS: Totally 73 cases(82 eyes)glaucoma patients were randomly divided into group A 37 cases(42 eyes)and group B 36 cases(40 eyes)which received compound and simple trabeculectomy respectively, all patients were followed up for 3 months and the incidence of shallow anterior chamber, bleb formation and control of intraocular pressure of both groups were observed and compared.

RESULTS: The incidence of shallow anterior chamber of group A and group B were 4.8%(Ⅰ degree)and 35.0%(Ⅰdegree+Ⅱdegree)respectively, the difference between groups was statistically significant(P<0.05); to the end of follow-up, 38 eyes(90.5%)got functional bleb in group A and 28 eyes(70.0%)got functional bleb in group B, the functional bleb formation rate had statistical difference between groups(P<0.05); in 3 months post-operation, a total of 37 eyes(88.1%)got complete control of intraocular pressure in group A which was significantly higher than group B(52.5%), the difference between groups was statistically significant(P<0.05); the mean intraocular pressure of group A in 3 months post-operation was 15.2±2.3mmHg which was significantly lower than group B(18.5±2.5mmHg), the difference between groups was statistically significant(P<0.05).

CONCLUSION: Compound trabeculectomy can effectively reduce the incidence of postoperative shallow anterior chamber; its efficacy is also obvious in functional filtering bleb formation and intraocular pressure control which is significantly better than that of simple trabeculectomy.