青光眼小梁切除术中应用生物羊膜与丝裂霉素治疗的观察

To observe the results of trabeculectomy with biotic amniotic membrane(AMT)or mitomycin C(MMC)in the treatment of glaucoma

目的观察生物羊膜与丝裂霉素C(MMC),应用于青光眼小梁切除术中治疗青光眼的临床疗效。方法随机选择39例(48只眼),分为羊膜组(22只眼)和丝裂霉素组(26只眼)。羊膜组施行小梁切除术联合巩膜瓣下生物羊膜植入术,丝裂霉素组施行小梁切除术联合巩膜瓣下放置丝裂霉素C,浓度为0.25 mg/ml,时间2分钟,术后随访3-9月,比较两种手术方式的临床疗效。结果术后与术前相比:两组眼压均明显降低。术后并发症:羊膜组副反应小,引起的并发症主要有术后浅前房;丝裂霉素组引起的并发症主要有滤过泡渗漏、低眼压等。结论小梁切除联合生物羊膜植入术可有效地减少瘢痕组织形成,且并发症较丝裂霉素少,是治疗青光眼安全、有效的手术方法。

Objetive To observe the results of trabeculectomy with biotic amniotic membrane（AMT） or mitomycin C（MMC） in the treatment of glaucoma. Methods Thrity-nine cases（48 eyes）of glaucoma were randomly divided into 2 groups, AMT group （ 22- eyes ） and MMC group（26-eyes）, AMT cases was trabeculectomy with AMT transplanted under the scleral flap;MMC cases was trabeculectomy with lay aside MMC under the scleral flap,0.25mg/ml via a sponge for 2minutes.The follow up was 3-9months,comparing the effect of two kinds of surgery. Results Comparing the postoperative with preoperative,the intraocular pressure of the two groups significantly declined.The postoperative complications induced by AMT were rare,mainly involving the shallow anterior chamber,whereas those by MMC involving were bleb leaking,lower lOP etc. Conclusion Biotic amniotic membrane implantation combined with trabeculectomy can reduce scar formation and improve the success rate,and the complications were more rare those of MMC .It is safe and effective to be used in operation of glaucoma.