巩膜池成形联合小梁切除及羊膜植入术治疗青光眼

Clinical study of sclera concave pool forming combined with amniotic membrane implantation and trabeculectomy for the treatment of glaucoma

目的:探讨巩膜池成形联合小梁切除及羊膜植入术治疗青光眼的临床疗效。方法:将临床收治的196例276眼青光眼患者施行巩膜池成形联合小梁切除及羊膜植入术,对比术后与术前眼压、并发症、房水流畅系数、滤过泡形态。随访3～16mo。结果:眼压术后1wk及1a不用降眼压药物情况下眼压控制在16～21mmHg;并发症:浅前房、低眼压及脉络膜脱离发生率低于10%;房水流畅系数平均0.28Cumm/min.mmHg;滤过泡形态为功能性滤过泡。结论:巩膜池成形联合小梁切除及羊膜植入术治疗青光眼降压效果明显,可以有效的抑制滤过泡的瘢痕组织形成,并发症少,是治疗青光眼安全、有效的手术方法,可以作为常规手术实施。

AIM ：To explore the effect of sclera concave pool forming combined with amniotic membrane implantation （AMI） and trabeculectomy for the treatment of glaucoma. METHODS： One hundred and ninety-six patients（276 eyes） with refractory glaucoma underwent sclera concave pool forming combined with AMI and trabeculectomy. The intraocular pressure （lOP）, outflow facility, anterior chamber and filtering blebs were observed, and all the patients were follwed up for 3 to 16 months. RESULTS：The postoperative lOP were controlled in 16- 21mmHg one week or one year after operation without ocular hypotensive agents; Incidences of complications such as shallow of anterior chamber, ocular hypotension, detachment of choroids were lower than 10%. The average coefficient of outflow facility was 0. 28Cumm/min · mmHg. The morphous of filter bleb was functional filter bleb. CONCLUSION： Application of sclera concave pool forming combined with AMI and trabeculectomy for the treatment of glaucoma can reduce blood pressure significantly, prevent the formation of scar tissue of filtering bleb, and the complications are rare. It is a useful and safe method for treating glaucoma.