非穿透性小梁手术治疗原发性开角型青光眼的临床观察

Observation of non-perforating trabecular surgery with reticulated hyaluronie acid implant for treatment of open-angle glaucoma

目的探讨非穿透性小梁手术（NPTS）联合透明质酸钠生物胶植入的临床疗效。方法对32例（38眼）原发性开角型青光眼实施非穿透性小梁手术联合透明质酸钠生物胶植入术。观察术后视力、眼压、滤过泡、前房反应、前房深浅及并发症。术后随访（14．6±2．3）月。结果术前平均眼压（29．2±8．01）mmHg。术后1周平均眼压（15．01±4．65）mmHg，手术前后眼压差异有统计学意义。术后30眼前房无任何反应，2眼有I度浅前房伴少许前房积血，均术后2～3d自行恢复，6眼轻度房水闪光，术后2～3d消失。所有患眼术后均形成显著弥散滤过泡。术后1周及6月视力基本稳定。结论非穿透性小梁手术联合透明质酸钠生物胶植入治疗开角型青光眼疗效肯定，并发症少，为开角型青光眼提供了一种更安全的治疗方法。

Objective To evaluate the clinical effect of non-perforating trabecular surgery （NPTS） combined with reticulated hyaiuronic acid implant onthe treatment of open, angle glaucoma. Methods NPTS combined with reticulated hyaluronic acid implant was performed on 38 eyes of 32 patients with open - angle glaucoma. Postoperative visual acuity, intraocular pressure GOP）, bleb appearance, anterior chamber reactions, anterior chamber depth and complications were observed. The mean follow - up was 14.6 ± 2.3 months. Results The mean preoperative IOP was 29.2 ± 8.01 mmHg. Aftrr operation,the mean IOP was 15.01±4.65 mmHg in the first week. The difference was significant（ P 〈0.01 ）. After operation, there was no flare in the anterior chamber in 30 eyes. In 2 eyes, there was a amall amount of hyphema that was absorbed in 2 - 3 days and there was shallow anterior chamber that disappeared in 2 -3 days. After operation, there was an obvious diffused bleb in each eye and the visual acuity was steady in the first week and in the sixth month. Conclusion The effect of nonperforating trabecular surgery with reticulated hyaluronic acid implant for treating open angle glaucoma is excellent. There are few complications. There-fore, NPTS is a promising and practicable anti-glaucoma surgery for treatment of open angle glaucoma.