小梁切除巩膜层间隧道房水引流术与MMC治疗难治性青光眼分析

A clinical study of trabeculectomy combined with scleral tunnel drainage and MMC for refractory glaucoma

目的探讨小梁切除巩膜层间隧道房水引流术与MMC治疗难治性青光眼的临床效果。方法采用随机对照的方法，将103例108只眼难治性青光眼随机分为两组，隧道组51例53只眼，采用小梁切除巩膜层间隧道房水引流加MMC进行手术治疗；小梁组52例55只眼，采用传统的小梁切除术加MMC。观察术后视力、眼压、滤过泡、手术成功率、并发症等情况。术后随访1-24个月。结果两组术后1个月视力比较无统计学意义（P〉0．05），术后12个月时光感至0．1、0．7至1．0有统计学意义（P〈0．05）。两组各时段眼压比较差异有统计学意义（P〈0.05）。功能性滤过泡分布情况各时期均有统计学意义（P〈0．05）。手术成功率12个月、24个月时两种比较均有统计学意义（P〈0．05）。结论小梁切除巩膜层间隧道房水引流术加MMC治疗难治性青光眼，术式简单易行，效果稳定可靠，手术成功率高，是治疗难治性青光眼较为理想的术式。

Objective To explore the clinical effect of treatment for refractory glaucoma of trabeculectomy combined with seleral tunnel drainage and mitomycin C.Methods A total of 103 patients （ 108 eyes） with refractory glaucoma were divided into two teams randomly, 51 patients （53 eyes） were treated with trabeculectomy combined with scleral tunnel drainage and mitomycin C, 52 patients （55 eyes） were treated with trabeculectomy combined with mitomycin C.Visual acuity, intraocular pressure, filtered bleb formation, successful rate and complication were compared postoperatively between the two teams.The follow-up period was 1 to 24 months postoperatively.Results There was no significant difference in visual acuity between two teams at 1 month post operation （P〉0.05）.There was significant difference between two teams in sense of light at 12 months post operation （P〈0.05）, in intraocular pressure （P〈0.05） and formation rate of functional filtered blebs （P〈0.05） at every period and in successful rate at 12 and 24 months post operation （P〈 0.05 ）.Conclusions Trabeculectomy combined with scleral tunnel drainage and mitomycin C is a kind of operation ideally for refractory glaucoma because of its easy application, reliable and stable effect and successful rate.