干燥羊膜移植联合复合式小梁切除术治疗难治性青光眼临床观察

Clinical observation of dry amniotie membrane transplantation combined with trabeculectomy for treatment of refractory glaueoma

目的探讨干燥羊膜移植联合小梁切除术治疗难治性青光眼的有效性和安全性。方法采用国产干燥羊膜移植联合复合式小梁切除术治疗难治陛青光眼32例（39眼），术后随访6～24个月，检查记录术后视力、滤过泡、前房深度、眼压及术后并发症等情况。结果随访期间眼压由术前（41.3±5．1）mmHg降至术后（17．2±5．3）mmHg，比术前降低59．9％，P〈0．001。手术总成功率为93．4％，保持功能性滤过泡34眼（87．2％），术后视力提高2行以上者为27眼（69．2％），并发症主要包括浅前房（5眼）、低眼压（9眼）和前房积血（4眼）。结论羊膜移植联合复合式小梁切除术可减少滤过道疤痕的形成，提高手术的成功率，是治疗难治性青光眼安全有效的方法之一。

Objective To explore the effect and security of dry amniotic membrane transplantation com- bined with trabeculectomy on refractory glaucoma.Methods Dry amniotic membrane transplantation combined with trabeculectomy was performed on 32 cases （39 eyes） with refractory glaucoma. All the patients were followed-up for 6- 24 months. The acuity of visual, filtering bleb, anterior chamber depth, IOP and the complications of operation were studied.Results The IOP was descended 59.9 % （P 〈 0.001） from （41.3±5.1）mmHg pre-operation to（17.2±5.3） mmHg post-operation. The total success rate was 93.4 %. After operation, 34 eyes （87.2 %） were kept functional filtering bleb. 27 eyes （69.2 %） had improved visual acuity. The complications included shallow anterior chamber （5 eyes） and early postoperative hypotony （9 eyes）. Conclusions Amniotic membrane transplantation combined with trabeculectomy for refractory glaucoma can effectively inhibit the scar formation, decrease the IOP and increase the success rate considerably. The method is safe and effective in the treatment of refractory glaucoma.