黏弹剂扩张术联合Schlemm管切开治疗闭角型青光眼效果观察

Observation of effect of viscoelastic agents dilatation combined with schlemm canal incision in the treatment of angle-closure glaucoma

目的探讨黏弹剂扩张术联合Schlemm管切开治疗闭角型青光眼的效果观察。方法选择2011年1月~2014年6月我院闭角型青光眼患者80例,分为两组,各40例,观察组实施黏弹剂扩张术联合Schlemm管切开,对照组实施小梁切除术,比较所有患者治疗前后两组眼压、前房深度及视力变化情况并统计两组治疗期间发生的并发症情况。结果观察组发生眼压增高、虹膜损伤以及前房周边出血的比例显著低于对照组（P〈0.05）,两组术前眼压、前房深度及视力等比较差异无统计学意义（P〉0.05）,治疗后观察组眼压低于对照组（P〈0.05）,前房深度浅于对照组（P〈0.05）,视力优于对照组（P〈0.05）。结论黏弹剂扩张术联合Schlemm管切开治疗闭角型青光眼,能有效达到房水引流效果,减低眼内压、加深前房深度,改善术后视力,手术安全效果理想,值得临床推广。

Objective To explore effect of viscoelastic agents dilatation combined with schlemm canal incision in the treatment of angle-closure glaucoma. Methods 80 patients with angle-closure glaucoma who were admitted to our hospital from January 2011 to June 2014 were selected and they were allocated to the observation group and the control group, with 40 in each. Patients in the observation group were received viscoelastic agents dilatation combined with schlemm canal incision while patients in the control group were received trabeculectomy. Intraocular pressure, anterior chamber depth and vision changes before and after treatment of two groups were compared. In addition, complications during treatment were recorded. Results Increased intraocular pressure, iris injury and the proportion of peripheral anterior chamber hemorrhage of the observation group were all significantly lower than those of the control group（P〈0.05）. Differences of intraocular pressure, anterior chamber depth and vision before treatment of two groups had no statistically significance（P〉0.05）. Intraocular pressure after treatment of the observation group was lower than that of the control group（P〈0.05）. Anterior chamber depth of the observation group was less deeper than that of the control group（P〈0.05）. Visual acuity of the observation group was superior to that of the control group（P〈0.05）. Conclusion Viscoelastic agents dilatation combined with schlemm canal incision in the treatment of angle-closure glaucoma can achieve the effect of aqueous humor drainage, reduce intraocular pressure, deepen the anterior chamber depth and improve visual acuity. It is safe with an ideal effect which is worthy of clinical promotion.