生物羊膜在难治性青光眼复合式小梁切除术中应用的临床观察

Clinical study of bio-amnion implantation used in combined trabeculectomy for refractory glaucoma

目的:观察生物羊膜在难治性青光眼复合式小梁切除术中应用的临床疗效。方法:选择我院46例62眼难治性青光眼患者,随机分为两组,A组为观察组32眼,行复合式小梁切除联合生物羊膜植入术,B组为对照组30眼,行复合式小梁切除术。观察术后眼压、滤过泡、视力、前房及角膜、术后并发症。结果:随诊12mo,眼压:两组手术前后各时间点眼压均明显降低(P<0.01)。术后12mo平均眼压:A组为12.3±2.3mmHg,B组为15.7±2.7mmHg,两组术后各时间点眼压无统计学意义(P>0.05)。滤过泡:术后12mo A组功能型滤过泡28眼(88%),B组功能型滤过泡20眼(67%),两组间有统计学意义(P<0.05)。A组发生浅前房5眼(16%),脉络膜脱离2眼(6%),B组浅前房3眼(10%),脉络膜脱离2眼(7%),滤过泡渗漏1眼(3%)。结论:复合式小梁切除术联合生物羊膜植入治疗难治性青光眼能有效提高手术成功率。

AIM：To evaluate the clinical effect of trabeculectomy combined with bio-amnion implantation for patients with refractory glaucoma. METHODS： Totally 62 eyes of 46 glaucoma patients were randomly divided into 2 groups. In group A, 32 eyes underwent trabeculectomy combined with bio-amnion implantation. In group B,30 eyes were as control group. The intraocular pressure （ IOP ）, filtrative bleb, visual acuity and complications were observed. RESULTS： Following-up 12 months, the postoperative conditions were compared with those before the surgery. The lOP of both groups was significantly declined （P 〈 0.01）. The average lOP in group A was about 12. 3 ± 2.3mmHg,while in group B was about 15.7 ± 2.7mmHg. 88% was Ⅰ and Ⅱ bleb in group A, 67% was Ⅰ and Ⅱ bleb in group B. There was significant difference between two groups （ P 〈 0.05）. Postoperative complications： shallow anterior chamber：5 eyes in group A,3 eyes in group B; choroidal detachment：2 eyes in group A ,2 eyes in group B; bleb leaking：l eye in group B. CONCLUSION： Combined trabeculectomy with bioamnion implantation can increase the success ratio in refractory glaucoma surgery.