巩膜瓣可拆除缝线小梁切除术远期疗效观察

Efficacy and Complications of Trabeculectomy with Removable Scleral-flap Suture and Mitomycin C

目的观察巩膜瓣可拆除缝线小梁切除术联合应用丝裂霉素C的远期疗效和术后早期并发症。方法65例(86眼)采用巩膜瓣可拆除缝线小梁切除术联合应用丝裂霉素C,同期46例(50眼)采用传统小梁切除术,比较手术后两组早期的低眼压、浅前房、脉络膜渗漏性脱离、黄斑水肿等并发症和远期的眼压控制效果。结果一年后的平均眼压,A组(17.3±6.41)mm Hg,B组(16.6±9.11)mm Hg,1年后两组间平均眼压的差异无统计学意义。术后早期浅前房A组11例(11眼),B组14例(14眼),浅前房发生率两组间的差异有统计学意义。A组未发生脉络膜脱离,B组发生3例(3眼),两组病例均未发生低眼压性黄斑病变和睫状环阻塞性青光眼。结论巩膜瓣可拆除缝线小梁切除术联合应用丝裂霉素C能有效地控制术后早期并发症,远期控制眼压效果与传统小梁切除无明显差别。

Objective To observe trabeculectomy with removable scleral - flap suture and mitomycin C （MMC） , evaluate its efficacy and complications a term of one year in the patients of glaucoma. Methods Sixty - five patients （ eighty - six eyes） underwent removable suture trabeculectomy with MMC as group A. Forty - six patients （fifty eyes） underwent routine trabeculeetomy as group B. Intraoeular pressure （IOP） , anterior chamber （AC） , complications were evaluated preoperatively and up to 12 months postoperatively. Results After 1 year postoperatively the average IOP of group A was（ 17.3 ± 6.41 ） min Hg, and group B was（ 16.6 ± 9. 11 ） mm Hg. The difference of average IOP after 1 year postoperatively between two groups were not significant. The incidence of shallow anterior chamber was significantly different between two group. Group A （ 11 eyes） was lower than that of Group B （ 14 eyes）. Choroidal detachment was not happened in group A. Three eyes happened choroidal detachment in group B. Other complications were not found in two groups. Conclusion Using removable scleral - flap suture trabeculeetomy with MMC technique can reduce the incidence of complications effectively. Long term postoperaterly, the average IOP of two groups is similar.