外伤性房角后退性青光眼手术方法选择的研究

Study of surgical methods for traumatic angle recession glaucoma

摘要:

目的：探讨外伤性房角后退性青光眼手术方法的选择。

方法：选取2014-02/2015-06在我院接受手术治疗的外伤性房角后退性青光眼患者94例94眼，其中术前眼压<30mmHg、房角后退范围≤180°、视盘C/D≥0.6患者选择常规小梁切除术(A组，n=63)； 术前眼压30～39mmHg，房角后退范围>180°，视盘C/D在0.6～0.8患者选择复合式小梁切除术(B组，n=24)； 术前眼压>39～50mmHg，房角后退范围>180°，视盘C/D在0.8～1.0患者选择青光眼引流阀植入术(C组，n=7)； 观察患者术前及术后12mo眼压、视力、有效滤过泡及并发症情况。

结果：A组、B组和C组术后12mo眼压分别为14.31±1.17、15.04±1.20、15.10±2.10mmHg，均较术前明显降低(P<0.05)； 三组患者术后眼压比较差异无统计学意义(P>0.05)； A组、B组和C组术后视力改善比例分别为90%、83%和86%，差异比较无统计学意义(P>0.05)； A组、B组和C组术后有效滤过泡比例分别为92%、92%和86%，差异比较无统计学意义(P>0.05)。A组、B组和C组术后视野计分较术前明显降低(P<0.05)。

结论：根据患者房角后退范围、眼压情况选择不同的手术方式治疗，能有效降低眼压，提高患者视力。

Abstract:

AIM: To investigate selection of surgical methods for traumatic angle recession glaucoma.

METHODS:. A total of 94 patients 94 eyes with traumatic angle recession glaucoma were selected from Feb. 2014 to Jun. 2015 in our hospital. The preoperative intraocular pressure <30mmHg, angle recession range ≤ 180 degrees, and optic disc C/D≥ 0.6 patient received normal trabecular resection(A group, n=63); Preoperative intraocular pressure ≥30 mmHg, ≤39mmHg, angle recession range >180 degrees, optic disc C/D 0.6 ～ 0.8 patients received composite trabecular resection(B group, n=24). Preoperative intraocular pressure >39mmHg to 50mmHg, angle recession range > 180 degrees, optic disc C/D in 0.8 to 1.0 patients received glaucoma drainage valve implantation(C group, n=7), observed patients preoperative and postoperative 12mo the intraocular pressure, visual acuity, effective filtering bleb and complications.

RESULTS: A group, B group and C group postoperative intraocular pressure were 14.31±1.17mmHg, 15.04±1.20mmHg and 15.10±2.10mmHg, compared with the preoperative decreased significantly(P<0.05). Three groups postoperative intraocular pressure difference had no statistical significance(P>0.05). The proportion of postoperative visual acuity improvement in A group, B group and C group were 90%, 83% and 86%, the difference was not statistically significant(P>0.05). The percentage of effective filtration bleb in A group, B group and C group were 92%, 92% and 86%, the difference was not statistically significant(P>0.05). A group, B group and C group postoperative visual field score compared with the preoperative decreased(P<0.05).

CONCLUSION: According to the patient's angle recession range and intraocular pressure choose different surgical treatment, can effectively reduce the intraocular pressure, improve the patient's visual acuity.