持续高眼压下小梁切除术中调整巩膜瓣缝线对疗效的影响

Efficacy of Adjustable Sutures Applied in Trabeculectomy under Sustained High Intraocular Pressure

【目的】探讨持续高眼压下小梁切除术中调整巩膜瓣缝线对疗效的影响。【方法】观察组30例（32眼）急性闭角型青光眼持续性高眼压下行小梁切除手术，术中采用可调整缝线方法；对照组30例（32眼）急性闭角型青光眼持续性高眼压下行小梁切除手术，术中未采用可调整缝线方法。观察两组术后前房形成和眼压情况并作统计学分析。【结果】术后浅前房发生率观察组为12．50％（4眼），对照组为31．25％（9眼），两组眼压比较差异有统计学意义（P〈0．01）。术后随访6个月，观察组随访到20眼，18眼眼压低于21mmHg（90．00％）；对照组随访到22眼，15眼眼压低于21mmHg（68．18％）。两组眼压比较差异有统计学意义（P〈0．01）。【结论】对持续高眼压下小梁切除中做调整巩膜瓣线，能有效预防术后浅前房发生，减少手术并发症是安全有效的，使手术的成功率明显提高。

[Objective] To explore the effect of adjustable sclera flap suture in trabeculectomy under sustained high intraocular. [Methods] The observation group （30 cases, 32 eyes） with acute angle-closure glaucoma underwent trabeculectomy under sustained high intraocular and adopted adjustable suture during operation. The control group （30 cases, 32 eyes） with acute angle-closure glaucoma underwent trabeculectomy under sustained high intraocular without adjustable suture. The formation of anterior chamber and the intraocular pressure were observed and analyzed statistically. [Results] The incidence of shallow anterior chamber after operation in observation group was 12.50% （4 eyes）, and in the control group was 31.25%（9 eyes）, and the difference in intraocular pressure between the two groups was statistically significant （ P 〈0.01）. After 6- month follow-up, 20 eyes in observation group were followed up, in which intraocular pressure of 18 eyes （90. 00%） was lower than 21mmHg. Twenty two eyes in the control group were followed up, in which intraocular pressure of 15 eyes （68. 18%） was lower than 21mmHg. The difference in intraocular pressure between the two groups was statistically significant （ P 〈0. 01）. [Conclusion]Adjustable scleral flap suture used in trabeculectomy under sustained high intraoeular pressure can effectively prevent the occurrence of postoperative shallow anterior chamber and reduce the complications of surgery, so that the surgical success rate can be increased significantly.