松解缝线小梁切除术治疗闭角型青光眼147例效果观察

Evaluation the cinical effect of trabeculectomy with releasable suture in the treatment of angle-close glaucoma

目的评价闭角型青光眼辅助巩膜瓣松解缝线小梁切除术的临床疗效。方法回顾性研究147例(159眼)原发性闭角型青光眼(PACG)施行辅助巩膜瓣松解缝线小梁切除术(简称松解缝线组),同期162例(174眼)PACG行常规小梁切除法(对照组),术后观察两组视力、眼压、前房形成、结膜滤泡、眼内反应等,平均随访时间30个月。结果术后早期前房形成时间(d),松解缝线组短于常规小梁切除组,差异有统计学意义(P<0.001)。松解缝线组出院时眼压(11.77±3.37)mmHg与术前眼压(31.63±9.45)mmHg比较,差异显著(t=25.86,P=0.000)。术后长期随访眼压(14.74±2.71)mmHg低于常规小梁切除组(17.96±2.45)mmHg,差异显著(t=11.22,P=0.000)。随访中无眼部感染与恶性青光眼发生。结论辅助巩膜瓣松解缝线的小梁切除术在闭角型青光眼滤过术中能促进术后早期前房形成。增强长期眼压控制作用。

Objective To evaluate the clinical effect of trabe- culectomy with releasable suture in treatment of angle-gluaucoma patients. Methods Clinical data of 147 patients （159 eyes） undergone trabeculectomy with releasable suture （releasable suture group） and 162 patients （ 174 eyes） undergone routine trabeculectomy （control group） were retrospectively reviewed. Before and surgery, visual acuity, lOP, depth of the anterior chamber, filtration bleb of each patient was under carefully observed. The mean follow-up period was 30 months. Results In patients went trabeculectomy with releasable sutures, the time for stable anterior chamber formation after the surgery, which was significantly shorter than the control group（P 〈0.00i ）. The post-operative IOP in the releasable suture group was （ 11.77 ± 3.37 ） mmHg, which was significantly （t = 25.86, P = 0. 000） lower than it was before the surgery （31.63 ± 9.45） mmHg. At the last visit, the IOP of the releasable suture group was （ 14.74 ±2.71 ） mmHg, which was again significantly （ t = 11.22,P = 0. 000） lower than the IOP of the control group （ 17.96 ± 2.45 mmHg）. Neither ocular infection nor malignant glaucoma was observed in the releasable suture group. Conclusion Trabeculectomy with releasable suture benefits the anterior chamber formation after surgery and long-term IOP control in the treamtment of angle-close glaucoma.