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[摘要]
目的:研究透明质酸钠在青光眼小梁切除术中的临床效果。
方法:将46例青光眼患者随机分为观察组(23眼)和对照组(23眼)。观察组在小梁切除术中应用0.4g/L的MMC棉片,缝合结膜瓣前在巩膜瓣下及前房内注入少量玻璃酸钠。对照组仅应用MMC,而不用玻璃酸钠。术后观察前房形成、眼压、角膜内皮损伤、滤过泡形成情况等。
结果:术后1d观察组眼压高于对照组,差异有统计学意义(P<0.05); 术后3d,1、6mo两组患者眼压比较差异无统计学意义(P>0.05); 术后3d,观察组视力下降2眼(9%),对照组8眼(35%),差异有统计学意义(P=0.035),术后6mo,观察组视力下降0眼(0),对照组5眼(22%),差异有统计学意义(P=0.025); 术后7d观察组与对照组的浅前房发生情况、术后6mo的滤过泡形成情况、角膜内皮细胞计数等项比较,两组差异均有统计学意义(P<0.05),观察组结果优于对照组,术后并发症观察组少于对照组。
结论:在青光眼小梁切除术中联合应用玻璃酸钠,可以增加手术安全性,有效预防早期浅前房、晚期滤过泡瘢痕化的发生。
[Key word]
[Abstract]
AIM:To study the clinical effects of using sodium hyaluronate in the glaucoma trabeculectomy.
METHODS: Totally 46 patients were included in our research and they were divided into two groups. In the study group(23 cases 23 eyes), we used slice with MMC of 0.4mg/mL in trabeculectomy. Before the conjunctiva flap was sewed, a small amount of sodium hyaluronate was injected into the space under scleral flap and the anterior chamber. In control group(23 cases 23 eyes), we only used MMC. After trabeculetomy, shallow anterior chambe formation, intraocular pressure, corneal endothelial injury and the formation of filter-bubble were observed in long term.
RESULTS: IOP of study group at 1d after operation was higher than that of control group(P<0.05), but not significant different at 3d, 1 and 6mo after operation(P>0.05). At 3d after operation, visual acuity decreased in 2 eyes(9%)of study group, 8 eyes(35%)in control group with significant different(P=0.035). At 6mo after operation, visual acuity decreased in 0 of study group, 5 eyes(22%)in control group with significant different(P=0.025). The differences on the occurrence of shallow anterior chamber at 7d after operation, formation of filter-bubble at 6mo after operation and corneal endothelial count were significant(P<0.05). There were less postoperative complications in study group than in control group.
CONCLUSION: Using sodium hyaluronate combined with MMC in trabeculectomy can greatly prevent the formation of shallow anterior chamber, filter-bubble scarring, and corneal endothelium dropout, make it possible to a safer surgery and a better outcome.
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