功能不良性滤过泡结膜下分离注射干扰素α-2b疗效观察

Needle revision of dysfunctional blebs with subconjuncitval injection of interferon α-2b

目的 评价针刺分离联合结膜下注射干扰素α-2b治疗青光眼小梁切除术后早期功能不良性滤过泡的有效性和安全性.方法 对23例（27只眼）小梁切除术后早期发生的功能不良性滤过泡行针刺分离联合干扰素α-2b结膜下注射,随访时间6个月以上,采用Van Buskirk裂隙灯显微镜分型法和Leung前节-OCT检查法相结合评估滤过泡治疗前后的形态和功能.结果 功能不良性滤过泡的发生时间为术后（51.04±23.09）d（19～89d）.治疗前患眼眼压为（22.77±8.65）mmHg（10～45mmHg））,随访终点眼压为（16.68±3.37）mmHg（7.70～21mmHg）,两者差异有统计学意义（P=0.002）.治疗的完全成功率为66.67%（18只眼）,条件成功率为25.93%为（7只眼）,总有效率为92.6%.治疗的主要并发症为滤过泡区结膜下出血（37%）和结膜破裂（22.22%）,治疗后无明显远期并发症.结论 针刺分离联合滤过区结膜下注射干扰素α-2b是治疗功能不良性滤过泡安全有效的方法,采用AS-OCT能客观、及时评估功能不良性滤过泡的形态和功能变化.

Objective To study the efficacy and safety of needle revision with subconjunctival interferon injection in eyes with dysfunctional blebs.Methods A series of 23 cases（27eyes）underwent trabeculotomy were determined as dysfunctional blebs with the form and function with slit-lamp and AS-OCT.Primary needling with 5×105 IFN α-2b injection was performed for the dysfunctional blebs.All cases were followed up for at least 6 months.Results Dysfunctional blebs developed 51.04±23.09d（19d-89d）after the surgery.The mean intraocular pressure（IOP）decreased significantly from 22.77±8.65mmHg（10-45mmHg）at diagnosis of dysfunctional blebs to 16.68±3.37mmHg（7.70-21mmHg）at the lavs visit（P=0.002）.Of the 27 eyes,18（66.7%）achieveda successful result,7（25.93%）were qualified successes.The most frequent complicatiom were Conjunctival hemorrhage（37%）and Conjunctiva tears（22.22%）.No serious complications happened.Conclusions The needling procedure associated with subconjuctival injection of IFN α-2b is a safe and effectivc method in treating dysfunctional blebs.