黏弹物质小管切开术治疗原发性开角型青光眼的临床研究

Clinical research on viscocanalostomy in the treatment of primary open-angle glaucoma

目的观察黏弹物质小管切开术(VCO)治疗原发性开角型青光眼(POAG)的临床效果。方法对原发性开角型青光眼30眼采用黏弹物质小管切开术治疗,30眼行传统小梁切除术(TE)治疗。观察两组患眼手术前后的眼压、视力及术中、术后并发症。结果术后随访2～12个月,黏弹物质小管切开术组视力无1例下降,平均眼压由术前43.15 mmHg改善为出院时11.20 mmHg,无任何严重并发症发生。传统小梁切除术组视力下降5例,平均眼压由术前42.77 mmHg改善为出院时11.50 mmHg。术中前房出血4例;术后浅前房5例,脉络膜脱离1例,两组术中、术后并发症比较有显著性意义(P<0.01)。结论黏弹物质小管切开术能很好地降低原发性开角型青光眼病人的眼压,术中、术后并发症少,是治疗原发性开角型青光眼安全而有效的手术方法,可推广应用。

Objective To investigate the clinical effect of viscocanalostomy（VCO） in the treatment of primary open-angle glaucoma. Methods Thirty eyes of primary open-angle glaucoma received VCO, and thirty eyes received trabeculectomy （TE）. Intraocular tension, visual acuity, and complication of intro-and post-operation were observed in two groups. Results Patients were followed up for 2 to 12 months after surgery. Visual acuity decreased in none, average intraocular tension improved from 43. 15 mmHg of pre-operation to 11.20 mmHg of discharge, and no serious complication was observed in the VCO group. While in the TE group, visual acuity decreased in 5 cases,average intraocular tension improved from 42.77mmHg of pre-operation to 11.50 mmHg of discharge, and hyphema in 4 cases, shallow anterior chamber in 5 cases and choroidal detachment in 1 case were observed. There were significant differences in the intro-and post-operation complication between the two groups （ P 〈 0. 01 ）. Conclusion VCO can effectively decreases intraocular tension of primary open-angle glaucoma patient with less intro-and post-operation complication. It is a safe and effective operation for primary open-angle glaucoma and worthy of application and generalization.