青光眼小梁切除手术中可调节缝线对早期泪膜功能影响

Effect on early tear film function of different adjustable suture in glaucoma trabeculectomy

目的:探讨青光眼小梁切除术中可调节线对患者早期泪膜功能影响。方法:选择2012-01/2014-04期间在我院行青光眼小梁切除手术治疗的原发性青光眼患者68例76眼,根据治疗方式将患者分为暴露结膜缝线(小梁切除)组(34例36眼)和包埋结膜(可调节)缝线组(34例40眼),分别给予可调节缝线暴露结膜缝合和包埋结膜缝合。观察两组患者治疗前及治疗后7,14,30d测眼压情况,同时进行Schirmer试验、泪膜破裂时间,记录两组患者治疗后1,30d不良反应发生情况。结果:治疗后两组患者平均眼压均较治疗前显著降低(P<0.05)。治疗后1d两组患者平均眼压比较无统计学差异(P>0.05),治疗后7,14,30d包埋结膜缝线组平均眼压显著高于暴露结膜缝线组(P<0.05)。治疗后1d两组患者Schirmer试验、泪膜破裂时间比较无统计学差异(P>0.05),治疗后7,14,30d包埋结膜缝线组Schirmer试验、泪膜破裂时间显著优于暴露结膜缝线组(P<0.05)。治疗后30d包埋结膜缝线组不良反应发生率显著低于暴露结膜缝线组(P<0.05)。结论:小梁切除手术可调节线包埋结膜缝合对患者早期泪膜功能影响较小,术后并发症较低,手术效果优于暴露结膜缝合。

AIM： To compare the effects of different adjustable suture in glaucoma trabeculectomy on early tear film function.METHODS： Sixty-eight cases of primary glaucoma（ 76eyes） during January 2012 to June 2014 in our hospital were selected and divided into exposure conjunctival suture group（ 34 cases, 36 eyes） and embedded conjunctival suture group（ 34 cases,40 eyes） according to treatment. Adjustable suture exposed conjunctival suture and embedding conjunctival suture was given to two groups, respectively. Intraocular pressure（ IOP）before and after treatment 7,14,30 d were observed and Schirmer test,tear break- up time,No Hikaru sensitivity and the occurrence of adverse reactions after treatment 1,30 d were recorded.RESULTS： After the treatment,the mean IOP of two groups were decreased significantly（ P 〈 0. 05）. The average IOP after treatment of 1d in the two groups were not statistically different（ P 〉 0. 05）,after treatment 7,14,30 d embedded conjunctival suture group was significantly higher than that of exposure conjunctival suture group（ P〈0. 05）. After 1d of treatment,Schirmer test,tear break- up time,No Hikaru sensitivity of two groups compared no significant difference（ P 〈 0. 05）. After treatment 7,14,30 d embedded conjunctival suture group Schirmer test,tear break- up time,was significantly superior to expose conjunctiva suture group（ P 〈 0. 05）. The 30 d package after treatment of conjunctival suture group buriedadverse reaction rate was significantly lower than that of exposed conjunctival suture group（ P 〈 0. 05）.CONCLUSION： Trabeculectomy operation with adjustable thread embedding conjunctival suture has few effects on the tear film function in patients with early postoperative complications,lower,and operation effect is better than that of exposed conjunctival suture.