复合小梁切除术治疗前葡萄膜炎继发青光眼

Compound trabeculectomy on secondary glaucoma following anterior uveitis

目的观察应用玻璃酸钠的复合小梁切除术治疗前葡萄膜炎继发青光眼的临床疗效。方法 观察组共37例(37眼)前葡萄膜炎继发青光眼,经药物治疗眼压仍不能控制而行复合小梁切除术,术中向巩膜瓣下及前房内注入玻璃酸钠0.2 mL;以同期行复合小梁切除术的29例(29眼)前葡萄膜炎继发青光眼作为对照,术中于巩膜瓣下及前房内注入0.2 mL平衡盐溶液。术后监测并记录视力、眼压、前房深度、前房角及滤过泡情况,随访9～15个月。结果与对照组比较,观察组手术成功率及功能性滤过泡比率较高,滤过瘘口开放较好,术后早期浅前房发生率较低,差异有统计学意义(P<0.05)。两组间视力改善差异无显著性(P>0.05)。结论对前葡萄膜炎继发青光眼行复合小梁手术,应用玻璃酸钠能减少滤过道黏连,明显提高手术质量及成功率。

Objective To investigate the clinical efficacy of compound trabeculectomy combined with sodium hyaluranate on secondary glaucoma following anterior uveitis.Methods During the process of compound trabeculectomy,sodium hyaluranate was injected into the anterior chamber and under the sutured scleral flaps in 37 cases（37 eyes） of the experimental group.The other 29 cases（29 eyes） in the control group were injected with B.S.S.solution.Visual acuity,intraocular pressure,thickness and angle of anterior chamber and the type of blebs in the two groups were recorded and statistically analyzed.Postoperative follow-up ranged from 9 to 15 months.Results A significant difference in the success rate was found between the two groups（P0.05）.The incidences of a functional filtration blebs and filtration patency were significantly higher in the experimental group than in the control group（P0.05）.The incidence of a flat anterior chamber was significantly lower in the experimental group than in the control group（P0.05）.No significant difference was found in the visual acuity improvement between the two groups（P0.05）.Conclusion A small amount of sodium hyaluranate injected into the anterior chamber and under the sutured scleral flap can restrain filtration adherence and raise surgery quality of compound trabeculectomy on secondary glaucoma following anterior uveitis.