小梁切除术联合胶原膜植入治疗难治性青光眼20例观察

Trabeculetomy Combined with Implantation of Collagen Membrane for the Treatment of Intractable Glaucoma

目的 观察小梁切除联合胶原膜植入治疗难治性青光眼的效果及并发症。方法 本组 2 0例难治性青光眼 ,其中新生血管性青光眼 4例 ,先天性青光眼 4例 ,外伤性青光眼 2例 ,滤过手术失败青光眼 10例 ,采用小梁切除术联合胶原膜植入 ,术后观察眼压及并发症。结果 术后 6个月测量眼压 :15 .88～ 3 5 .76mmHg( 1mmHg =0 .13 3 3kPa) ,平均眼压为 ( 15 .77± 6.0 0 )mmHg。 17只眼术后眼压降至 2 1.0 0mmHg以下 ,仅 3只眼压高于 2 1.0 0mmHg。未发现严重并发症及胶原膜排斥反应。 结论 胶原膜植入联合小梁切除术是治疗难治性青光眼的有效方法 。

Objective To explore the effect and postoperative complications of trabeculectomy combined with implantation of collagen membrane for intractable glaucome. Methods Fifteen eyes with intractable glaucoma,including 4 eyes with neovascular glaucoma,4 eyes with congenital glaucoma ,2 eyes with glaucoma secondary to trauma,10 eyes with failed filtering surgery glaucoma, were performed trabeculectomy with implantation of collagen membrane.The postoperative lowering-pressure outcome and complications also were observed.Results All patients were follow up for 6 months.The postoperative intraocular pressure of patients was 15.88～35.76mmHg (mean 15.77±6.00 mmHg ) at 6 months of post- operation. The postoperative intraocular pressure was below 21.00 mmHg in 17 eyes,and higher than 21.00 mmHg only in 3 eyes.No serious complications and rejection related to implatation of collagen membrane occurred in this group during the follow up period.Conclusion Trabeculectomy combined with implantation of collagen membrane seems to be an ideal procedure for treatment of intractable glaucoma, especially in vast country hospital in china, this surgery also can replace the expensive import drainage device implant therapy for intractable glaucoma.