外伤性房角后退性青光眼手术方法选择的研究

Study of surgical methods for traumatic angle recession glaucoma

目的:探讨外伤性房角后退性青光眼手术方法的选择。方法:选取2014-02/2015-06在我院接受手术治疗的外伤性房角后退性青光眼患者94例94眼,其中术前眼压<30mmH g、房角后退范围≤180°、视盘C/D≥0.6患者选择常规小梁切除术(A组,n=63);术前眼压30~39mmH g,房角后退范围>180°,视盘C/D在0.6~0.8患者选择复合式小梁切除术(B组,n=24);术前眼压>39~50mmH g,房角后退范围>180°,视盘C/D在0.8~1.0患者选择青光眼引流阀植入术(C组,n=7);观察患者术前及术后12mo眼压、视力、有效滤过泡及并发症情况。结果:A组、B组和C组术后12mo眼压分别为14.31±1.17、15.04±1.20、15.10±2.10mmH g,均较术前明显降低(P<0.05);三组患者术后眼压比较差异无统计学意义(P>0.05);A组、B组和C组术后视力改善比例分别为90%、83%和86%,差异比较无统计学意义(P>0.05);A组、B组和C组术后有效滤过泡比例分别为92%、92%和86%,差异比较无统计学意义(P>0.05)。A组、B组和C组术后视野计分较术前明显降低(P<0.05)。结论:根据患者房角后退范围、眼压情况选择不同的手术方式治疗,能有效降低眼压,提高患者视力。

AIM： To investigate selection of surgical methods for traumatic angle recession glaucoma. METHODS：. A total of 94 patients 94 eyes with traumatic angle recession glaucoma were selected from Feb. 2014 to Jun. 2015 in our hospital. The preoperative intraocular pressure 〈30mmHg, angle recession range ≤ 180 degrees, and optic disc C/D≥ 0.6 patient received normal trabecular resection（A group, n=63）; Preoperative intraocular pressure ≥30 mmHg, ≤39mmHg, angle recession range 〉180 degrees, optic disc C/D 0.6 ～ 0.8 patients received composite trabecular resection（B group, n=24）. Preoperative intraocular pressure 〉39mmHg to 50mmHg, angle recession range 〉 180 degrees, optic disc C/D in 0.8 to 1.0 patients received glaucoma drainage valve implantation（C group, n=7）, observed patients preoperative and postoperative 12mo the intraocular pressure, visual acuity, effective filtering bleb and complications.RESULTS： A group, B group and C group postoperative intraocular pressure were 14.31±1.17mmHg, 15.04±1.20mmHg and 15.10±2.10mmHg, compared with the preoperative decreased significantly（P〈0.05）. Three groups postoperative intraocular pressure difference had no statistical significance（P〉0.05）. The proportion of postoperative visual acuity improvement in A group, B group and C group were 90%, 83% and 86%, the difference was not statistically significant（P〉0.05）. The percentage of effective filtration bleb in A group, B group and C group were 92%, 92% and 86%, the difference was not statistically significant（P〉0.05）. A group, B group and C group postoperative visual field score compared with the preoperative decreased（P〈0.05）. CONCLUSION： According to the patient＇s angle recession range and intraocular pressure choose different surgical treatment, can effectively reduce the intraocular pressure, improve the patient＇s visual acuity.