巩膜瓣顶角可调节缝线在闭角型青光眼手术中的应用

Application of scleral adjustable sutures in surgery for angle closure glaucoma

目的:探讨巩膜瓣顶角可调节缝线在闭角型青光眼患者小梁切除联合巩膜瓣下生物羊膜植入术中的应用价值。方法:回顾性分析行小梁切除联合巩膜瓣下生物羊膜植入术的闭角型青光眼患者94例106眼临床资料,根据其术中是否应用巩膜瓣顶角可调节缝线的情况分为研究组54例60眼(术中应用巩膜瓣顶角可调节缝线)和对照组40例46眼(术中未应用巩膜瓣顶角可调节缝线)。观察比较两组患者术后2wk内早期浅前房、持续性浅前房及相关并发症发生情况,分析其术后3mo内功能性滤过泡形成情况,记录术前及术后1mo眼压改善情况。结果:术后2wk内,研究组早期浅前房及持续性浅前房发生率均明显低于对照组,差异有统计学意义(P<0.05),两组并发症发生率比较差异无统计学意义(P>0.05)。术后1mo,两组患者眼压均较术前明显降低,差异有统计学意义(P<0.05),且研究组手术前后眼压差值显著大于对照组,差异有统计学意义(P<0.05)。术后3mo时,研究组功能性滤过泡形成率明显高于对照组,差异有统计学意义(P<0.05)。结论:将巩膜瓣顶角可调节缝线用于小梁切除联合巩膜瓣下生物羊膜植入术中,可有效降低浅前房发生风险,对改善闭角型青光眼患者眼压、功能性滤过泡形成等具有积极意义。

·AIM： To explore the application value of scleral adjustable sutures in trabeculectomy and scleral biological amniotic membrane implantation for angle closure glaucoma. ·METHODS： The clinical data of 94 patients （106 eyes） with angle closure glaucoma who underwent trabeculectomy and scleral biological amniotic membrane implantation were analyzed retrospectively. According to scleral adjustable suture used, the subjects were divided into the application group （ study group, 54 patients 60 eyes） and the non-application group （ control group, 40 patients 46 eyes ） . The occurrence of early shallow anterior chamber, continuous shallow anterior chamber and related complications in 2wk after surgery was observed and compared between the two groups. The formation of functional filtration bleb in 3mo after surgery was analyzed, and the improvement of intraocular pressure before surgery and 1mo after surgery was recorded. ·RESULTS： In 2wk after surgery, the incidence rates of early shallow anterior chamber and continuous shallow anterior chamber in the study group were significantly lower than those in the control group （P〈0. 05）, while there were no significant differences in the incidence rates of complications between the two groups （P〉0. 05）. One month after surgery, the intraocular pressure of the two groups were significantly lower than that before surgery （P〈 0. 05 ）, and the difference of intraocular pressure before and after surgery in the study group was significantly higher than the control group. Three months after surgery, the formation rate of functional filtration bleb in the study group was significantly higher than that in the control group （P〈0. 05）. ·CONCLUSION： The application of scleral adjustable sutures in trabeculectomy and scleral biological amniotic membrane implantation can effectively reduce the risk of shallow anterior chamber, which is of positive significance in improving intraocular pressure and formation of functional bleb in patients with angle closure glaucoma.