治疗用绷带镜对复合小梁切除术后早期结膜切口渗漏的疗效

EFFECT OF THERAPEUTIC BANDAGE CONTACT LENS ON EARLY CONJUNCTIVAL INCISION LEAKAGE AFTER COMPLEX TRABECULECTOMY

目的探讨小梁切除术后早期结膜切口渗漏应用治疗用绷带镜的临床效果。方法选取2014年8月—2017年2月承德医学院附属医院诊治的34例(34只眼)接受结膜瓣以穹窿为基底的小梁切除术后早期结膜切口渗漏的原发性青光眼患者,随机分为戴镜组和传统组,所有患者常规药物治疗,戴镜组连续配戴角膜绷带镜,传统组采用传统绷带局部加压包扎,观察治疗后结膜切口愈合、患者眼部主觉症状、视力、眼压及前房情况,评估角膜绷带镜在青光眼术后结膜切口渗漏方面的疗效。结果结膜平均愈合时间戴镜组(5.06±2.44)d,传统组(6.94±2.62)d,差异有统计学意义(P<0.05)。治疗前戴镜组与传统组主觉症状评分比较差异无统计学意义(P>0.05);治疗后1 d、3d、7d戴镜组主觉症状评分均低于同时间传统组,差异均有统计学意义(P<0.05)。二组患者治疗后1周最佳矫正视力、眼压与治疗前比较,差异均无统计学意义(P>0.05);二组患者治疗后1周中央前房深度与治疗前比较,差异均有统计学意义(P<0.05)。结论治疗用绷带镜治疗复合式小梁切除术后早期结膜切口渗漏,比传统绷带局部加压包扎更有优势。

Objective To explore the clinical effect of therapeutic bandage contact lens on early conjunctival incision leakage after trabeculectomy.Methods Thirty-four primary glaucoma patients（34 eyes）with early conjunctival incision leakage after conjunctival formin trabecular resection were enrolled in the study from August 2014 to February 2017 in author’s hospital.The patients were randomly divided into wearing lens group and traditional group,and the patients were treated with conventional drugs.Wearing lens group continuous weared bandage contact lens,traditional group accepted traditional bandage local pressure bandage.Conjunctival incision healing,subjective symptoms,vision,intraocular pressure and anterior chamber were observed to evaluate effect of therapeutic bandage contact lens on conjunctival incision leakage after glaucoma surgery.Results Conjunctiva average healing time were（5.06 ± 2.44）days in wearing lens group and（6.94 ± 2.62）days in traditional group,the difference was statistically significant（P 〈0.05）.There was no significant difference in scores of subjective symptoms between the two groups before treatment（P〉0.05）.The scores of subjective symptoms were significantly lower than those of the same time traditional group at 1 day,3 days and 7 days after treatment,the difference was statistically significant（P〈0.05）.There was no significant difference in best corrected visual acuity and intraocular pressure in the two groups at 1 week after treatment compared with before treatment（P〉0.05）.There was significant difference in anterior chamber depth at 1week after treatment compared with before treatment（P〈0.05）.Conclusion Therapeutic bandage contact lens on early conjunctival incision leakage after complex trabeculectomy is more advantages than traditional bandage local pressure bandage.