改良复合式小梁切除术治疗原发性闭角型青光眼的效果观察

Observation of the Effect of Modified Compound Trabeculectomy on Primary Angle-Closure Glaucoma

目的:观察改良复合式小梁切除术治疗原发性闭角型青光眼的效果。方法:选择在本院接受治疗的76例原发性闭角型青光眼患者的病历资料,依据治疗方法不同分为改良组与传统组,传统组采用传统小梁切除术,改良组采用改良复合式小梁切除术,比较两组患者的功能性滤过泡形成率,比较两组患者术前术后的眼压和浅前房发生率。结果:改良组患者在术后2周和半年的功能性滤过泡(Ⅰ~Ⅱ型)形成率均明显高于传统组,P<0.05,组间差异有统计学意义。两组患者术前的眼压无明显差异,P>0.05,无统计学意义,具有可比性。术后1周,测得两组患者的眼压均明显低于术前,在随诊的半年中,两组患者的眼压均呈现上升趋势,但在各阶段,改良组患者的眼压均明显低于传统组,改善更好,P<0.05,组间差异有统计学意义。改良组浅前房发生率为2.6%(1/38),明显低于传统组的34.2%(13/38),P<0.05,组间差异有统计学意义。结论:采用改良复合式小梁切除术治疗原发性闭角型青光眼,促进功能性滤过泡形成,能更好地维持患者远期眼压,提高治疗效果,减少术后并发症的发生,值得推荐。

Objective:To observe the effect of modified compound trabeculectomy in the treatment of primary angle closure glaucoma.Methods:76 patients with primary angle closure glaucoma in our hospital were selected and divided into improved group and traditional group according to different treatment methods.The traditional group was treated with traditional trabeculectomy,and the improved group was treated with modified compound trabeculectomy.Results:The formation rate of functional filtering bleb(type I^II)in the improved group was significantly higher than that in the traditional group 2 weeks and half a year after operation,P<0.05,and the difference between the two groups was statistically significant.There was no significant difference in intraocular pressure between the two groups(P>0.05).One week after the operation,the intraocular pressure of the two groups was significantly lower than that before the operation.In the half year of follow-up,the intraocular pressure of the two groups showed an upward trend,but in each stage,the intraocular pressure of the improved group was significantly lower than that of the traditional group,and the improvement was better,P<0.05,the difference between the two groups was statistically significant.The incidence of shallow anterior chamber in the improved group was 2.6%(1/38),which was significantly lower than 34.2%(13/38)of the traditional group,P<0.05.Conclusion:Modified compound trabeculectomy in the treatment of primary angle closure glaucoma can promote the formation of functional filtering bleb,better maintain the long-term intraocular pressure,improve the treatment effect and reduce the incidence of postoperative complications,which is worthy of recommendation.