高眼压状态下青光眼手术治疗效果分析

Under High-tension Glaucoma Surgery Effectiveness Analysis

目的:比较高眼压与正常眼压状态下青光眼手术的安全性、可行性及治疗效果。方法:163例(174眼)青光跟患者,其中术前跟压控制不佳的青光眼患者83眼,以及91眼正常眼压下青光眼患者在显微镜下施行了小梁切除术,并在术中联合运用了丝裂霉素(MMC)和可拆缝线法,对于其中33例合并晶状体明显混浊的患者联合施行了小切口白内障囊外摘除术(MSICS)。结果:经成组设计资料两样本均数比较的μ检验,认为两种眼压状态下的青光眼手术,术后效果差异无统计学意义(P>0.05)。术后1周视力明显好于术前者(提高2排以上)占37.4%,无明显变化者占59.0%;眼压(4～25.81)mmHg,平均为(12.20±2.31)mmHg,功能性滤泡占96.4%,无严重并发症的发生。结论:对部分眼压控制不佳的青光眼患者术中采用眼球按摩或术中前房穿刺降压并联合运用MMC、可拆缝线法是一种相对安全、有效的治疗方法,与常规青光眼手术方法比较,手术效果间差异无统计学意义。

Objective： To compare the operative security, the feasibility and therapeutic effect of high-tension and normal-tension glaucoma surgery state. Methods： 163 cases （174 eyes） with glaucoma, in which preoperative intraocular pressure of glaucoma patients with poor control 83, and 91 cases of normal-tension glaucoma patients, under the microscope introduced in trabeculectomy and intraoperative use of joint Mitomycin C （MMC） and removable suture, 33 cases for which the merger of lens opacities in patients with marked joint implementation of a small incision extraeapsular cataract extraction （MSICS）. Results： The results of design information by the group number of the two samples are compared ~t inspection, that the state of the two intraocular pressures in glaucoma surgery, after the effect of the difference was not significant （P〉 0.05）. 1 week after eye surgery is better than the former （up 2 line above） accounted for 37.4 %, no significant changes were accounted for59.0 %;IOP（4-25.81） mmMg, an average of（12.20 ± 2.31） mmHg, functional follicular accounted for 96.4 %, without serious complications. Conclusion： To some poor control of intraocular pressure in glaucoma patients, with ocular massage or the use of intraoperative anterior chamber puncture and the joint use of antihypertensive MMC, removable suture is a relatively safe and effective treatment method, and compared with conventional methods of glaucoma surgery, the operative results of two sets have no significam difference.