复合式小梁切除术中两种可调节缝线的方法及其比较

Comparison of two ways for adjustable suture in complex trabeculectomy

目的：比较两种可调节缝线方法存复合式小梁切除术巾的应用。方法：随机选取54例青光眼患者施行复合式小梁切除术联合从结膜瓣出针的可调节巩膜瓣缝线术，60例青光眼患者施行复合式小梁切除术联合从透明角膜出针的可调节巩膜瓣缝线术，并将两组手术效果进行比较。结果：术后远视力无明显变化。术后第1d 114眼（全部）前房形成。第一组患者均存2wk内拆除可调节缝线。第二组患者中，若眼压始终在靶眼压以下者则保留可调节缝线。所有患者随访3—12mo，眼压均在9～21mmHg之间。两组患者自觉症状的比较：在拆除可调节缝线前，第一组患者有明显的眼部磨痛症状的有49例，伴有明显的分泌物的有29例。第二组患者有明显的眼部磨痛症状的有6例，伴有明显的分泌物的有5例。二者的差别有统计学意义（P〈0．01）。第二组患者中，若眼压始终在靶眼压以下者则保留可调节缝线。结论：复合式小梁切除术联合两种可调节巩膜瓣缝线术，均简单易行，并且都取得了良好的术后效果。从透明角膜出针的可调节巩膜瓣缝线术后患者不适症状较少，是理想的手术操作方法。

AIM： To compare the two ways of adjustable suture in complex trabeculectomy. METHODS. Fifty-four eyes with glaucoma （group one） were operated by complex trabeculectomy combined with adjustable suture of scleral flap from conjunctival flap. Sixty eyes with glaucoma （group two） were operated by complex trabeculectomy combined with adjustable suture of scleral flap from transparent cornea. And the two ways were compared. RESULTS. Far The adjustable vision didn＇t change clearly after operation. suture was removed in 2 weeks after operation in group one, while it maybe retained in group two if IOP was lower than target tension. All patients were followed up for 3-12 months, and the lOP of them was between 9-21mmHg. The patients in group one had more obviously uncomfortable symptoms （pain and secretion） than those in group two （ P〈 0.01 ）. CONCLUSION. The two ways of adjustable suture in complex trabeculectomy can be operated easily, and have good effect. The patients have less uncomfortable symptoms with adjustable suture of scleral flap from transparent cornea, so it is an ideal way.