经烧烙自体巩膜在非穿透性小梁手术中应用的研究

Nonperforating trabecular surgery and cauterized autoplasty sclera in glaucoma

目的观察非穿透性小梁手术(Nonperforating trabecular surggery,NPTS)联合经烧烙自体巩膜植入术治疗青光眼的临床效果。方法将39例(48眼)原发性开角型青光眼患者分为两组,实验组NPTS+经烧烙自体巩膜植入,对照组单纯NPTS。术后观察眼压、视力、滤过泡形态、并发症等,并做超声生物显微镜(UBM)观察。结果经12个月随访成功率实验组为91.7%,对照组为66.7%。术后1～12个月实验组眼压明显低于对照组(P<0.01)。术后3～12个月实验组功能性滤过泡及减压室存留情况均多于对照组(P<0.05),术后6～12个月实验组睫状体脉络膜上腔低回声暗区多于对照组(P<0.05)。结论非穿透性小梁手术联合经烧烙自体巩膜植入术,能有效降低眼压,经济安全术后视力稳定,值得临床应用推广。

Objective To evaluate the clinical results of nonperforating trabecular surgery and cauter-ized autoplasty sclera in glaucoma. Methods 48 eyes of 39 patients withPrimary open-angle glaucoma were divided into 2 groups, experimental group： NPTS and sclera cauterized autoplasty, control group： simple NPTS. The postoperative intraocular pressure （lOP）, intraocular reactions, the bleb status and the compli- cations were recorded. The changes in ultrasound biomicroscopy （UBMO wre analyzed. Results The patients were followed up 12 months. The rate of success was 91.7 % in the experimental group and 66.7 % in the control group, IOP of the experimental group was much lower than the control group in 1 to 12 months after surgery, the difference being statistically different （ P 〈 0.01 ）. Postoperative functional blebs and in- trascleral space under UBM of the experimental group were more than the control group in 3 to 12 months after surgery （ P 〈 0.05）. Choroid low echo section under UBM of the experimental group were more than the control group in 6 to 12 months after surgery （P〈0.05）. Conclusions Nonperforating trabecular surgery and cauterized autoplasty sclera proceduce is effective, cheap, ~fe and worth to be applied in clinic.