改良手术治疗原发性闭角型青光眼疗效分析

Clinical effect of modified operation for glaucoma treatment of primary angle closure glaucoma

目的探讨改良青光眼手术治疗原发性闭角型青光眼的临床疗效。方法临床病例对照研究。对2012年1月至2013年10月在大丰市第二人民医院眼科就诊的38例44只眼原发性急性闭角型青光眼患者，分为对照组（A组18例20只眼）和改良组（B组20例24只眼）两组，局麻下分别行传统小梁切除术和改良青光眼手术。术后随访1—12个月。观察并比较两组的浅前房发生率、滤过泡形成情况以及眼压控制情况。结果对照组及改良组术后早期浅前房发生率、术后长期眼压控制及功能性滤过泡形成率比较差异均有统计学意义（P〈0．05），改良组手术效果优于对照组。结论采用改良式青光眼手术治疗青光眼，具有术中操作简便，术后并发症少，降眼压效果较好，前房较稳定，滤过泡形成好，并发症少等优点，是确实可行的手术方法。

Objective To explore the clinical effect of modified operation for glaucoma treat- ment of primary angle closure glaucoma. Methods Thirty-eight cases （44 eyes） of primary acute an- gle closure glaucoma patients were randomly divided into control group （group A, 18 eyes of 20 cas- es） and modified group （group B, 20 cases 24 eyes）. Of two groups were performed under local an- esthesia, operation with traditional or improvement of traditional trabeculectomy respectively. Patients were followed up for 1-12 months after operation. The two groups were observed and compared the incidence of shallow anterior chamber, filtering bleb formation and intraocular pressure. Results There were statistically significant differences （P 〈0.05） between control group and modified group on the early postoperative shallow anterior chamber, the incidence of postoperative long-term IOP control and functional filtering bleb formation rate, the modified group operation was better than the control group. Conclusions The improved type of glaucoma surgery is simple, less postoperative complications, good intraocular pressure lowering effect, more stable anterior chamber, and functional filtering bleb formation. The operation method is really feasible.