青光眼小梁切除联合巩膜瓣下羊膜填充的疗效观察

The efficiency of trabeculectomy combined with amniotic membrane insertion for glaucoma.

目的探讨青光眼小梁切除联合巩膜瓣下羊膜填充治疗青光眼的疗效。方法对12例（12眼）青光眼行小梁切除手术，术中联合巩膜瓣下羊膜填充，观察术后并发症的发生和滤过泡的形成以及术后眼压变化。结果（1）眼压：术后3月内，12眼眼压均在10～21mmHg；术后6月，有1眼需用1种降眼压滴眼液使眼压控制在21mmHg以内。（2）滤过泡：滤过泡Ⅰ、Ⅱ型滤过泡10眼；Ⅱ型滤过泡2眼。（3）并发症：术后前房有渗出反应8眼，前房有少量积血1眼，均在1周内恢复。结论小梁切除联合巩膜瓣下羊膜填充，在一定程度上提高了青光眼滤过手术的成功率。

Objective To evaluate the effect of trabeculectomy combined with amniotic membrane insertion for patients with glaucoma. Methods Twelve eyes of 12 patients with glaucoma were underwent trabeculectomy combined with amniotic membrane insertion. Post-operative complication, filtering bleb and intraocular pressure were observed. Results （1）Intraocular pressure：Among the 12 eye of 12 patients underwent this procedure, intraocular pressure was controlled to between 10 and 21 mmHg in the first 3 months after surgery in all （ 100% ） eyes. Intraocular pressure of one eye was controlled to less than 21 mmHg with use of one kind of anti-glaucoma eye drops in the sixth month after surgery. （2） Filtering bleb： the bleb classification were referred to Kronfeld＇ s classification system of filtering blebs. The rate of Kronfeld＇ s type Ⅰ and Ⅱ bleb was 83.3%, type Ⅲ bleb was 16.7 % . （3） Complications ： Eight case （66.7 % ） with anterior chamber exudation and one case （8.3 % ） with small hyphema were found postoperatively. But they all recovered in a week. Conclusions Trabcculectomy combined with amniotic membrane transplantation can increase the chance of success in glaucoma surgery to some extent.