球结膜瓣下植入生物羊膜在难治性青光眼滤过手术中的应用

Clinical study of bio-amnion implantation in conjunctive flap used in glaucoma trabeculectomy

目的：观察难治性青光眼小梁切除术中不同位置植入生物羊膜对滤过泡及眼压的影响。方法：随机选择我院住院45例难治性青光眼患者，随机分为三组，A组为小梁切除术后球结膜下植入生物羊膜（15眼），B组为小梁切除术后巩膜瓣下植入生物羊膜（15眼）。C组为单纯小梁切除术（15眼）术后观察眼压，滤过泡，以及术后并发症。结果：随访6mo，A组术后眼压平均波动为11．80～21．22mmHg，B组术后眼压平均波动为12．48～21．52mmHg，C组术后眼压平均波动为10．60～28．48mmHg，术后6mo条件成功率A、B、C三组分别为93．3％，86．7％，66．7％。结论：生物羊膜能有效提高难治性青光眼滤过手术的条件成功率。球结膜下植入羊膜操作简单，条件成功率高于其他两组，同时加固了球结膜，减少薄壁滤过泡的发生。

AIM： To observe the effect of different implantation position of bio-amnion used in glaucoma trabeculectomy through filtrative bleb and intraocular pressure. METHODS： Forty-five eyes of glaucoma were randomly divided into 3 groups. In group A, biological amnion was implanted in 15 eyes under conjunctive flap; In group B, biological amnion was implanted in 15 eyes under scleral flap. Group C was as control group. We observed the effect of intraocular pressure, filtrative bleb and complications. RESULTS： The average intraocular pressure in group A was about 11.80-21.22mmHg during 6 months follow-up, 12.48-21.52mmHg in group B, and 10.60-28.48mmHg in group C. Conditional successful rate of group A , B and C was 93.3%, 86.7% ,66.7% respectively. CONCLUSION： Bio-amnion implantation improves effectively the rate of success in glaucoma trabeculectomy. The operation of bio-amnion implantation position used in conjunctive flap is simple and has a conditional successful rate compared with other groups, which reinforce conjunctive flap and prevent frail filtrative bleb.