超声生物显微镜在“三明治”式人羊膜移植治疗难治性青光眼疗效评价中的作用

The Usefulness of UBM in Evaluation Sandwich Style Human Amniotic Membrane Transplantation for Refractory Glaucoma

目的评价超声生物显微镜(UBM)在"三明治"式人羊膜移植术后随访中的作用。方法对49例(50只眼)难治性青光眼行小梁切除联合"三明治"式人羊膜移植术,术后1、3、6、9、12个月行UBM检查滤过泡的形态、滤过泡内腔大小、巩膜瓣下形成液间腔的大小(最大宽和高)、羊膜的变化情况,眼压情况。结果①滤过泡形态:低回声型为50%,高回声型为40%,包裹型为6%,平坦型为4%。②滤过泡内腔大小:术后1个月,最宽处平均为(3.23±0.21)mm,最高处平均为(0.68±0.12)mm,术后3个月,最宽处平均为(3.12±0.16)mm,最高处平均为(0.63±0.12)mm,术后6个月,最宽处平均为(3.04±0.11)mm,最高处平均为(0.59±0.06)mm,术后9个月,最宽处平均为(3.00±0.09)mm,最高处平均为(0.55±0.11)mm,术后12个月,最宽处平均为(2.98±0.11)mm,最高处平均为(0.53±0.20)mm,前9个月比较,最大宽和高差异有统计学意义(P<0.05)。③巩膜瓣下液间腔的大小:术后1个月,最宽处平均为(2.07±0.21)mm,最高处平均为(0.47±0.16)mm,术后3个月,最宽处平均为(2.07±0.13)mm,最高处平均为(0.46±0.20)mm,术后6个月,最宽处平均为(2.06±0.23)mm,最高处平均为(0.45±0.16)mm,术后9个月,最宽处平均为(2.04±0.18)mm,最高处平均为(0.43±0.13)mm,术后12个月,最宽处平均为(2.03±0.22)mm,最高处平均为(0.42±0.27)mm,不同时期比较最大宽和高均无统计学差异(P>0.05)。④羊膜平均存留时间为(8.68±1.10)个月。结论 UBM是一种客观的、有效的随访工具,"三明治"式人羊膜移植术能有效保持滤过道的通畅。

Objective To evaluate the usefulness of UBM in follow-up after sandwich style human anmiotic membrane transplantation. Methods UBM was performed on 50 eyes after sandwich style human aumiotic membrane transplantation. 1 month, 3 month, 6 month, 9 month, 12 month after surgery, the bleb images, the height and the width of the intrableb and the filtration pathway under the scleral flap and intraocular pressure were measured. ResuRs ①The bleb images： the type of low-reflective is 50%, the type of high-reflective is 40%, the type of encapsulated is 6%, the type of flattened is 4%. ②The height and the width of the intrableb： 1 month, width is （3.23±0,21）mm, height is （0.68±0.12）mm, 3 month, width is （3.12±0.16）mm, height is （0.63±0.12）mm, 6 month, width is （3.04±0.11）mm, height is （0.59±0.06）mm, 9 month, width is （3.00~0.09）mm, height is （0.55±0.11）mm, 12 month, width is （2.98±0.11）mm, height is （0.53±0.20）mm. ③The filtration pathway under the scleral flap： 1 month, width is （2.07±0.21）mm, height is （0.47±0.16）mm,3 month, width is （2.07±0.13）mm, height is （0.46±0.20）mm, 6 month, width is （2.06±0.23）mm, height is （0.45±0.16）mm, 9 month, width is （2.04±0.1g）mm, height is （0.43±0.13）mm,12 month, width is （2.03±0.22）mm, height is （0.42±0.27）mm. ④About （8.68±1.10）months postoperation the amniotic membrane had melt. Conclusions UBM is a useful method for follow-up of sandwich style human amniotic membrane transplantation.