闭角型青光眼急性期行小梁切除并丝裂霉素联合羊膜移植术疗效观察

Clinical observation of trabeculectomy with biological amniotic membrane implantation and mitomycin C for acute primary angle closure glaucoma

摘要:

目的：探讨生物羊膜在闭角型青光眼急性期滤过手术中的应用疗效。

方法：对临床收治的闭角型青光眼急性期需行滤过手术的患者25例25眼施行小梁切除并丝裂霉素联合羊膜移植术，观察术后视力、眼压、前房形成、滤过泡及有无并发症等情况，评估其疗效。

结果：除1例患者术后视力下降外，其它患者视力变化均为不变或提高，术后1、3、7d，1mo视力变化差异有统计学意义(P<0.05)，术后3d～1wk视力达到稳定状态； 所有患者术前与术后各时间点眼压差异均有统计学意义(P<0.01)，术后1、3、7d，1、3、6、12mo眼压控制稳定； 前房形成良好，无并发症。

结论：在急性闭角型青光眼持续高眼压状态下，施行小梁切除联合应用低浓度丝裂霉素C及生物羊膜移植术，是安全有效的。

Abstract:

AIM: To evaluate the clinical effect of trabeculectomy combined with biological amniotic membrane implantation and mitomycin C for acute primary angle closure glaucoma.

METHODS: Twenty-five cases(25 eyes)with acute primary angle closure glaucoma underwent trabeculectomy combined with biological amniotic membrane implantation and mitomycin C. Clinical observations were carried out on the postoperative visual acuity, intraocular pressure, anterior chamber formation, filtering bleb and complications.

RESULTS:Except one patient whose postoperative visual acuity decreased, the visual acuity of others did not changed or improved, and the visual acuity at 1, 3, 7d, and 1mo were significantly different(P<0.05). At 3d to 1wk after operations, the visual acuity reached stable state. There were statistically significant differences on intraocular pressure before and after operations in all patients(P<0.01). The intraocular pressure remained stable during 1a after surgeries. The operation also maintained anterior chamber, formed functional filtering blebs and reduced the risk of complications.

CONCLUSION: Trabeculectomy combined with biological amniotic membrane implantation and mitomycin C is a safe and effective method for acute primary angle closure glaucoma.