羊膜移植联合低浓度丝裂霉素治疗原发性青光眼的临床疗效

Clinical Effect of Amnion Transplantation Combined with Low Concentration of Mitomycin for Primary Glaucoma

目的：探究羊膜移植联合低浓度丝裂霉素在治疗原发性青光眼的临床疗效。方法：选取2013年6月～2014年1月我院收治的原发性青光眼患者58例（80眼），按照随机数字表法分为观察组（30例，40眼）和对照组（28例，40眼），观察组行小梁切除、羊膜移植联合低浓度丝裂霉素治疗，对照组行小梁切除治疗，比较两组的手术效果及术后并发症情况。结果：观察组术后优良率为97％（38／40），显著优于对照组的75％（28／40），差异有统计学意义（χ2=9．764，P=0．008）；两组术后1、6个月眼压较术前均明显降低（P〈0．05），且观察组较对照组更低（P〈0．05）；观察组功能性滤泡明显多于对照组（χ2=4．943，P=0．026），术后并发症明显低于对照组（χ2=4．501，P=0．034），复发情况明显低于对照组（χ2=914，P=-0．047）。结论：羊膜移植联合低浓度丝裂霉素治疗原发性青光眼能够有效控制眼压，减缓患者视力的丧失，术后并发症及复发率均较低，值得临床推广。

Objective： To investigate the clinical effect of amnion transplantation combined with low concentration of mitomycin in the treatment of primary glaucoma. Methods： A total of 58 patients （80 eyes）with primary glaucoma, who were admitted to Ophthalmologic Hospital of Hainan Province from June 2013 to January 2014, were randomly divided into observation group （30 cases, 40 eyes） and control group （28 cases, 40 eyes）. The observation group was treated by trabeculectomy, amnion transplantation combined with low concentration of mitomycin, while the control group was only treated by trabeculectomy. The operative effect and occurrence of complications after operation were compared between the two groups. Results： Excellent and good rate（97%） of the observation group after operation was significantly better than that of the control group （75%）, the difference was statistically significant （χ2=9.764, P=0. 008）. Compared with before operation, the intraocular tension of the two groups was all decreased 1 month, 6 months after operation, and the intraocular tension of observation group was lower than that of the control group （P〈0.05）; the functional follicles of the observation group were obviously more than those of the control group （χ2=4.943, P=0.026）, and the occurrence of complication of the observation group was lower than that of the control group （χ2=4.501,P=0.034）, as well as the recurrence of the observation group, （χ2=3.914, P=0.047）. Conclusion： Anmion transplantation combined with low concentration of mitomycin has good efficacy in the treatment of patients with primary glaucoma, which can effectively control the intraocular tension, slow down the vision loss, and lower the occurrence of complication and recurrence, and is worthy of clinical application.