小梁切除联合生物羊膜植入术治疗闭角型青光眼的临床观察

Clinical study of bio-amnion implantation combined with trabeculectomy in angle-closure glaucoma

目的探讨小梁切除联合生物羊膜植入术治疗闭角型青光眼的临床疗效。方法将30例(36只眼)闭角型青光眼患者随机平均分为羊膜组和对照组,羊膜组行小梁切除术联合巩膜瓣下生物羊膜植入术,对照组行小梁切除术。术后随访1年,观察比较两组术前、术后1周、1、3、6个月及1年的视力、前房、滤过泡、房水流畅系数和眼压情况。结果术后1周两组视力变化情况无明显差异;术后1年,羊膜组保持功能性滤泡16只眼(88.89%),对照组12只眼(66.67%),两组差异有统计学意义;术后1周、6个月及1年羊膜组眼压均低于对照组,两组差异有统计学意义;术后6个月及1年羊膜组房水流畅系数均高于对照组,两组差异有统计学意义。结论小梁切除联合生物羊膜植入术可有效地减少瘢痕组织形成,并发症少,长期眼压控制好,手术成功率高,是治疗青光眼安全、有效的手术方法。

Objective To explore the effects of bio-amnion implantation combined with trabeculectomy in the treatment of angle-closure glaucoma. Methods 36 eyes of 30 patients with angle-closure glaucoma were randomly divided into two groups. Bio-amnion group underwent bio-amnion implantation combined with trabeculectomy and control group underwent trabeculectomy. The visual acuity, anterior chamber, filtering blebs, intraocular pressure （IOP） and coefficient of facility of outflow were observed. Results No obvious difference in the change of visual acuity occurred between bio-amni- on group and control group at lw after operation. 16 eyes （88.89%） maintained functional filtering blebs in bio -amnion group, and 12 eyes （66.67% ） in control group at la after operation. IOP of bio-amnion group was lower than control group at lw, 6m and la after operation. Coefficient of facility of outflow of bio-ainnion group was larger than control group at 6m and 1 a after operation. All the differences had statistical significance. Conclusion Bio-amnion implantation com- bined with trabeeuleetomy can reduce sear formation and improve the success rate. IOP after operation could be control well and complications are rare. It is safe and effective to be used in operation of angle-closure glaucoma.