UBM检查对青光眼术后滤过泡形态与眼压关系的临床观察

Clinical observation of relationship between filtering bleb shape and intraocular pressure after glaucoma surgery by UBM

目的分析超声生物显微镜（UBM）检查对抗青光眼小梁切除术后滤过泡分型及其与眼压的关系,进一步评判滤过泡功能。方法选取2016年3月-2017年1月在我院眼科行小梁切除术的患者60例,分别于术后2周、1个月、3个月及6个月采用UBM检查滤过泡形态;随访1~12个月,对不同时间滤过泡分型、滤过泡分型与眼压关系进行观察比较。结果 60例行小梁切除术的青光眼患者术后的滤过泡UBM形态及其与眼压的关系可以分为3型,即通畅型、阻塞型、临界型;术后2周观察滤过泡形态,即：功能型眼（61.67%）,非功能型眼（11.67%）,临界型眼（26.67）;术后1个月滤过泡形态：功能型眼（61.67%）,非功能型眼（13.33%）,临界型眼（25.00%）;术后3个月滤过泡形态：功能型眼（60.00%）,非功能型眼（15.00%）,临界型眼（25.00%）;术后6个月滤过泡形态：功能型眼（53.33%）,非功能型眼（21.67%）,临界型眼（25.00%）;不同细胞滤过泡分型患者眼压比较差异有统计学意义（P〈0.05）。结论青光眼小梁切除术后滤过泡有无功能可借助UBM做相应的判断：功能性滤过泡及手术后眼压保持平稳;非功能性滤过泡,术后早期即可出现眼压升高,临界型是介于非功能性与功能性中UBM检查间的特殊类型的滤过泡。

Objective To analyze the ultrasound biomicroscopy（UBM） examination on trabeculectomy bleb type and determine its relationship with intraocular pressure,further evaluation of bleb function.Methods 60 patients from March2016 to January 2017 in our hospital for trabeculectomy were selected.2 weeks after surgery,1,3 and 6 months according to the examination of UBM bleb morphology,follow-up time 1-12 months,the bleb in different time points.Type of filtering bleb and intraocular pressure relationship were observed.Results 60 patients with glaucoma underwent trabeculectomy blebs after UBM morphology and its relationship with intraocular pressure can be divided into three types,namely smooth type,blocking type and critical type;after 2 weeks of observation of filtering bleb,namely：functional eyes（61.67%）,non functional eyes（11.67%）,critical eye（26.67）;1 months after surgery,bleb morphology：functional eyes（61.67%）,non functional eyes（13.33%）,critical eye（25.00%）;after 3 months of filtering bleb morphology：functional eyes（60.00%）,non functional eyes（15.00%）,critical eye（25.00%）;6 months after surgery,bleb morphology：functional eyes（53.33%）,non functional eyes（21.67%）,critical eye（25.00%）;intraocular pressure in patients with different cell blebs type were statistically significant difference（P〈0.05）.Conclusion Glaucoma after trabeculectomy blebs have no function can help UBM do the corresponding judgment：functional bleb and intraocular pressure after surgery remained stable;non functional filtering bleb,postoperative early can lead to increased intraocular pressure,critical type is a special type of a non functional and functional check in UBM the bleb.