两种瓣式小梁切除术后辅助眼球按摩对形成功能性滤过泡的影响

Influence of auxiliary eyeball massage on the formation of functional filtering blebs after two kinds of conjunctiva flap trabeculectomy

目的:比较穹隆部为基底的球结膜瓣和角膜缘为基底的球结膜瓣在青光眼复合式小梁切除术后辅助眼球按摩治疗对形成功能性滤过泡的影响。方法:将51例61眼原发青光眼并接受复合小梁切除术患者随机分成两组:A组26例31眼以角膜缘为基底的球结膜瓣;B组25例30眼以穹隆部为基底的球结膜瓣。术后观察两组患者眼压、滤泡、前房深度,并根据情况适时辅助眼球按摩治疗。全部患者术后观察6mo。结果:两种结膜瓣的复合式小梁切除术均有显著降眼压效果(P<0.01);功能性滤过泡的形成率也无统计学差异(P>0.05);术后早期眼球按摩促进滤泡形成中出现被动性滤泡渗漏B组多于A组。结论:两种结膜瓣的复合小梁切除术治疗青光眼都有相同良好的效果。眼球按摩可促进形成功能性滤过泡。角膜缘为基底球结膜瓣的复合小梁切除术后眼球按摩治疗不易出现被动性滤泡渗漏。

AIM ：To compare the fornix-based conjunctival flap and corneal limbus-based conjunctival flap with auxiliary eyeball massage therapy on the formation of functional filtering bleb after compound trabeculectomy in glaucoma. METHODS：A total of 51 patients （61 eyes） with primary glaucoma and combined trabeculectomy were randomly divided into two groups： A group of 26 patients （31 eyes） were of limbus-based conjunctival flap; B group of 25 patients （30 eyes ） of fornix-based conjunctival flap. Postoperative Intraocular pressure, filtering bleb and anterior chamber depth were observed in two groups, and timely eyeball massage therapy was applied accordingly. All cases were observed for 6 months. RESULTS： Intraocular pressure lowering effect of two conjunctival flap combined trabeculectomy was both significant （ P 〈 0.01 ） ; functional bleb formation rate was no statistically significant difference （ P 〉 0.05） ; passive leakage of filtering bleb was more in B group than that of A group during eyeball massage＇ promotion of filtering bleb formation at early postoperative stage. CONCLUSION： The two conjunctival flap combined trabeculectomy for glaucoma have the same good results. Eyeball massage can promote the formation of functional bleb. Eyeball massage therapy after limbus-based conjunctival flap compound trabeculectomy has less passive filtering bleb leakaqe.