原发性开角型青光眼合并近视的手术疗效观察

Observation of the effect of surgery on primary open-angle glaucoma with myopia

目的 对比观察小梁切除术联合术中应用0．1g·L^-1丝裂霉素C和单纯小梁切除术后治疗原发性开角型青光眼合并近视的结果。方法 将28例50眼原发性开角型青光眼合并近视患者分为2组。A组：20例36眼，采用小梁切除术联合术中应用0．1g·L^-1丝裂霉素C，放置2min；B组：8例14眼，采用单纯小梁切除术。所有患者术后随访6～24月，平均13月。结果 术后1d、1周、1月2组眼压差异均无显著性（P〉0．05），术后3月、6月、12月眼压差异均有显著性意义（P〈0．05）；A组10眼视力下降，B组8眼视力下降，2组间有显著性差异（P〈0．05）；A组30眼、B组7眼有微小囊泡型和平坦、弥散型滤过泡，2组滤过泡构成有显著性差异（P〈0．05）；A组3眼、B组2眼术后早期有脉络膜脱离。A组5眼、B组1眼有轻度房水闪辉。结论 小梁切除术联合术中应用低浓度丝裂霉素C是治疗原发性开角型青光眼合并近视的一种有效的手术方法。

Objective To evaluate the results of trabeculectomy with the use of 0.1 g· L^- 1 mitomycin C（MMC）and without MMC in the treatment of primary open-angle glaucoma（POAG）with myopia. Methods Fifty eyes of 28 patients with primary open-angle glaucoma with myopia were divided into 2 groups randomly. In 36 eyes of 20 patients（group A） a sponge soaked with MMC was applied for 2 minutes in the scleral bed , and in 14 eyes of 8 patients（group B） without MMC. The mean follow up period was 13months （6-24 months）. Results The mean IOPs at postoperative 1 day, 1 week and 1 month were not significantly different between the two groups （P 〉 0.05）. At postoperative 3 months, 6 months and 12 months, the difference was significant（P〈 0.05）;The visual loss of 10 eyes in group A and 8 eyes in group B was significant different （P 〈 0.05 ）. Total 30 eyes in group A and 7 eyes in group B had microsac or diffuse blebs. There was significant different in the category of blebs between the two groups （ P 〈 0.05 ）. There were 3 eyes in group A and 2 eyes in group B with choroidal detachment, and 5 eyes in group A and 1 eye in group B with minimal anterior chamber reaction. Conclusion Trabeculecmoty with lower concentration MMC may be an effective method of operation to primary open-angle glaueoma with myopia.