粘弹剂钝性房角分离在闭角型青光眼治疗中的临床研究

Clinical Study on the Treatment of Closed Angle Glaucoma with the Blunt Angle of the Viscoelastic Agent

目的探索粘弹剂钝性房角分离在闭角型青光眼治疗中的应用价值。方法随机选取2014年1月—2015年12月该院眼科治疗的闭角型青光眼患者80例(90只眼),按手术方式分为2组;观察组(40例,46只眼):行青光眼小梁切除术联合粘弹剂钝性房角分离手术;对照组(40例,44只眼):单纯小梁切除术。比较术后两组患者的治疗效果。结果自第3天开始,比较对照组与观察组患者的眼压,差异具有统计学意义,尤其是1个月后对照组的眼压为(16.31±3.75),观察组为(13.05±2.89),明显低于对照组(P<0.05)。观察组术后发生浅前房的患者例数为2眼,占5.00%。对照组患者为11眼,占27.50%,二者比较差异具有统计学意义(P<0.05);观察组患者较术前深度增加;对照组患者术后第一日前房浅的较多,经过加压包扎或降低后房压力后,前房逐渐恢复至术前,术后仍然觉得前房很浅。结论粘弹剂钝性房角分离术能明显减少术后发生浅前房的情况,显著降低眼压,可应用于闭角型青光眼角膜条件不好或视力好不接受白内障手术的患者的青光眼治疗。

Objective To explore the application value of viscoelastic agent in the treatment of angle closure glaucoma.Methods Randomly selected in January 2014 to December 2015 in our hospital treatment of 80 cases of closure angle glaucoma patients（90 eyes）, according to the type of surgery, divided into two groups, the observation group（40 cases, 46eyes）： Glaucoma trabecular resection combined with viscoelastic agent blunt real angular separation surgery; control group（40 cases, 44 eyes）： Simple trabecular resection.Results Since the start of day 3, compared with the control group and the observation group of patients with intraocular pressure（IOP）, the difference is statistically significant, especially after 1month control group of intraocular pressure was（16.31± 3.75）, the observation group for（13.05 ± 2.89）, significantly lower than the control group（P〈0.05）. The observation group of patients with shallow anterior chamber occurred in 2 eyes, accounting for 5%. Control group patients for 11 eyes, accounting for 27.5%, the difference has statistical significance（P〈0.05）; observation group were compared with the preoperative depth increases; patients in control group were given after the first day of shallow anterior chamber more, after a compression bandage or reducing real pressure, anterior chamber recovered to the preoperative and postoperative still feel very shallow anterior chamber. Conclusion The viscoelastic agent to blunt the corner separation technique can significantly reduce postoperative shallow anterior chamber, significantly reduce intraocular pressure, can be applied to angle-closure glaucoma and corneal condition is bad or vision not accept treatment of cataract surgery in patients with glaucoma.