曲安奈德注射液结膜下注射在青光眼滤过术中的疗效观察

Observation on the Efficacy of Triamcinolone Acetonide Injection Subconjunctival Injection in Glaucoma Filtering Surgery

目的探讨曲安奈德注射液在急性原发性闭角型青光眼滤过术围手术期的应用效果。方法回顾性分析20例(28只眼)急性原发性闭角型青光眼行青光眼滤过术患者,所有病例均先行显微镜下青光眼小梁切除术+可调节缝线。所有病例随机分为两组(观察组及对照组)。观察组10例(16只眼),术毕下方球结膜下注射曲安奈德4 mg。对照组10例(12只眼),术毕常规下方球结膜下注射地塞米松2.5 mg。结果术后随访3个月~1年,观察组中1例(1只眼)(6.25%)滤过泡血管化粗大,滤过口阻塞。对照组3例(3只眼)(25%)滤过泡血管化,滤过口阻塞(P<0.05),有显著差异,提示青光眼滤过术毕结膜下注射曲安奈德注射液能明显降低滤过泡血管化,滤过口阻塞。结论曲安奈德注射液结膜下注射可以作为青光眼滤过术毕的常规应用。

Objective To investigate the effect of triamcinolone acetonide injection in the perioperative period of acute primary angle closure glaucoma filtering surgery. Methods 20 patients(28 eyes) with acute primary angle closure glaucoma who underwent glaucoma filtering surgery were retrospectively analyzed. All patients underwent microscopic trabeculectomy plus adjustable sutures.All cases were randomly divided into two groups(observation group and control group). In observation group, 10 cases(16 eyes) received subconjunctival injection of triamcinolone acetonide 4 mg after operation. In control group, 10 cases(12 eyes) were injected with dexamethasone 2.5 mg under bulbar conjunctiva after operation. Results Following up for 3 months to 1 year,1 case(1 eye)(6.25%) of the observation group had coarser vascularization and obstruction of the filter orifice. In the control group,3 cases(3 eyes)(25%) had filtering bleb vascularization and filtering orifice obstruction(P<0.05),which showed that subconjunctival injection of triamcinolone acetonide could significantly reduce filtering bleb vascularization and filtering orifice obstruction after glaucoma filtering operation. Conclusion Subconjunctival injection of triamcinolone acetonide injection can be used as a routine application after glaucoma filtration surgery.