不同植入物在非穿透小梁手术的临床观察

Clinical observation on non-penetrating trabecular surgery with different implants

目的探讨不同植入物在非穿透小梁手术(NPTS)中治疗开角型青光眼的临床疗效。方法将40例(54眼)原发开角型青光眼随机分为A、B、C三组,每组均为18眼。A组:NPTS+HealonGV植入。B组:NPTS+保存羊膜植入。C组:NPTS+透明质酸钠生物胶(SK-GEL)植入。术中全部眼联合丝裂霉素C及可调缝线,观察术后眼压、视力、滤过泡、前房、视野等。结果随访6～18个月,平均(9.32±4.81)个月,手术成功率:A组55.56%,B组88.89%,C组94.44%,B、C组与A组比较差异有统计学意义(P<0.05),而B和C两组间差异无统计学意义(P>0.05)。三组患者无前房变浅、炎症、脉络膜脱离、视力下降等并发症。结论NPTS植入物中SK-GEL及羊膜最好,HealonGV次之,羊膜更经济。

Objective To observe the clinical results of non -penetrating trabecular surgery （NPTS） with different implants in treatment of open angle glaucoma. Methods NPTS was performed on 40 cases of primary open angle glaucoma （54 eyes） that were randomly divided into three groups by each 18 eyes with different implants, group A ： Healon GV , B ： amniotic membrane , and C： SK-GEL. The postoperative intraocular pressure （lOP） , intraocular reactions and the bleb status were recorded. Results Follow-up （6-18 months） , the successful rates were 55.56 % （ A group） , 88.89% （B group） , and 94.44 % （C group） , respectively. There were significant differences in successful rates between B , C and A （P 〈 0.05 ） , but no difference between B and C （P 〉 0.05）. The complications such as flat chamber., inflammation and choroidal detachment were not observed , the visual acuity remain unchanged. Conclusions SK-GEL and amniotic membrane can be used for NPTS implants but not Healon GV, however amniotic membrane was much cheap.