小梁切除术联合羊膜植入治疗青光眼的疗效观察(1)
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【摘要】 目的 观察小梁切除术联合结膜瓣下植入生物羊膜对难治性青光眼的疗效。方法 随机选择64例(64眼)难治性青光眼,配对分为两组,分别施行小梁切除术(A组)或小梁切除联合结膜瓣下植入生物羊膜(B组)。术后观察眼压、滤过泡、术后并发症等情况。结果 随访30个月,手术成功者A组共14眼,成功率48.28%;B组26眼,成功率86.67%,两组差异有统计学意义(χ2=2.431,P=0.027)。两组术后并发症无显著差异。结论 小梁切除术联合结膜瓣下植入羊膜能显著提高难治性青光眼滤过手术的成功率。
【关键词】
青光眼;小梁切除术;羊膜;植入
Clinical Study of amnion implantation used in glaucoma trabeculectomy
LUO Rongjiang,SHAO Yingfeng,PENG Lingmei,et al.Department of Ophthalmology,The First Affiliated Hospital of Sun YatSen University,Guangzhou 510080,China
【Abstract】 Objective To observe the effect of bioamnion implantation inconjunctive flap used in
DOI:10.3760/cma.j.issn 16738799.2010.01.27
作者单位:510080 广州,中山大学附属第一医院(骆荣江 彭玲妹 刘韶瑞);
中山大学中山眼科中心(邵应峰 卓业鸿 田臻)
refractory glaucoma trabeculectomy.Methods Sixtyfour cases(64 eyes)of refractory glaucoma were randomly divided into 2 groups,32 cases with refractory glaucoma after simplical trabeculectomy were chosen for group A.In group B,32 cases with refractory glaucoma after trabeculectomy with amniotic membrane transplanted at random.We observed the effect of intraocular pressure,filtrate bleb and complications.The followup was 30 months.Results The cumulative success rate in amniotic membrane group was 86.67%(26 eyes),while that in control group was 48.28%(14 eyes).The difference between the two groups was significant.(χ2=2.431,P=0.027),but the incidence of complications had no obvious difference between the two groups.Conclusion Bioamnion implantation in conjunctive flap can improv effectively the rate of success in refractory glaucoma trabeculectomy.
【Key words】
Glaucoma;Trabeculectomy;Amnion;Implantation
小梁切除术是治疗青光眼的常用术式,但常由于术后滤过通道纤维化而导致青光眼,尤其是难治性青光眼的手术失败[1]。我们于2003年7月开始对部分难治性青光眼患者在施行小梁切除术的同时结膜瓣下植入生物羊膜,并就其疗效与并发症等情况与同时期施行常规小梁切除术者进行对照研究,报告如下。
1 对象和方法
1.1 对象 选择2005年7月至2008年10月收治的难治性青光眼患者共64例,按照青光眼类别相同、术前眼压相近(相差≤5 mm Hg)、年龄相近(相差≤5岁)的原则配对,随机分别施行常规复合式小梁切除术(A组)或小梁切除术联合结膜瓣下植入生物羊膜(B组)。
1.1.1 A组:共32例(32眼),施行复合式小梁切除术。其中,男17眼,女15眼,平均年龄49.44±12.23(34~72)岁,平均术前眼压36.28±7.56(28~42)mm Hg。
1.1.2 B组:共32例(32眼),施行小梁切除术联合结膜瓣下植入生物羊膜。其中,男13眼,女19眼,平均年龄47.58±13.20(32~71)岁,平均术前眼压37 ......
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