非穿透性小梁切除术联合羊膜植入治疗开角型青光眼

Treatment of Open Angle Glaucoma by Non-penetrating Trabeculectomy Combining with Amniotic Transplantation

目的:评价非穿透性小梁切除术(non-penetratingtrabecular surgery,NPTS)联合羊膜植入治疗开角型青光眼的临床疗效。方法:将23例(30只眼)具备手术适应证的开角型青光眼分为两组。Ⅰ组14例20眼,行NPTS联合羊膜植入术;Ⅱ组9例10眼,行NPTS手术联合透明质酸生物胶植入术。术后对两组患者的视力、眼压、滤过泡及并发症进行对比观察。结果:术后1个月时,Ⅰ组与Ⅱ组的视力变化比较,无显著差异(P>0.05);术后6、12、24月时,两组眼压值无显著差异(P>0.05)。Ⅰ组术后早期有少量前房积血2只眼,轻度房水闪光5只眼;Ⅱ组术后早期1只眼有轻度房水闪光。结论:NPTS联合羊膜植入术与NPTS联合透明质酸生物胶植入术分别用于治疗开角型青光眼,其术后降眼压效果均较好(P>0.05)。但前者的成本明显低于后者,可降低患者的经济负担。

Objective：To evaluate the clinical effect of non- penetrating trabecular surgery （NPTS） combining amniotic implantation in treatment of open angle glaucoma. Methods： 30 eyes from 23 patients with open angle glaucoma, who fitted the operative indications, were divided into 2 groups randomly. 20 eyes of patients （ group Ⅰ ） were performed by NPIS combining amnion implantation, on the other hand, 10 eyes of 9 patients （ group Ⅱ ） suffered NPIS and hyaluronic acid biogel implantation. The postoperative visual acuity, intraocular pressure （IOP）, filtering blebs and complications in two groups were compared. Results： The mean of follow - up periods was 20 months （ from 12 to 30 months）. The Visual acuity in postoperative 1 mouth was not significantly different between group Ⅰ and Ⅱ （ P 〉 0.05）. The means of IOP at postoperative 6, 12, and 24 months were not significantly different between the two groups（ P 〉 0.05） .There were 5 eyes present slight Tyndall phenomenon and 2 eyes a small quantity of anterior chamber hyphema at postoperative early stage in group Ⅰ . There was 1 eye with slightly aqueous flare at postoperative early period in group Ⅱ . Conclusion：The clinical effect of NPIS with amniotic transplantation is similar to that of NPIS combining hyalttronie acid implantation. The former could lessen patients＇ economic burden.