外伤性青光眼小梁切除术与激光周边虹膜切除术效果比较

Comparison between trabeculectomy and laser peripheral iridectomy in traumatic glaucoma

目的比较小梁切除术与激光周边虹膜切除术治疗外伤性青光眼的临床效果。方法回顾性病例对照研究。纳入洛阳博爱眼科医院2018年1月至2021年3月外伤性青光眼120例(120眼)分为两组:小梁切除术60例作为观察组,激光周边虹膜切除术60例作为对照组。对比分析两组患者的手术效果。结果术后1个月:观察组有效率为98.33%(59/60),高于对照组的86.67%(52/60)(χ^(2)=5.89,P=0.015);观察组视力(logMAR)优于对照组(t=33.87,P<0.001),眼压低于对照组(t=22.03,P<0.001);观察组治疗后Hcy、IL-6、TNF-α水平均较对照组更低(均P<0.001);观察组不良反应发生率为3.33%(2/60),低于对照组的15.00%(9/60)(χ^(2)=4.90,P=0.027)。结论小梁切除术较激光虹膜切除术能更好地改善外伤性青光眼患者的视力,缓解其眼压及炎症反应,还能降低其不良反应发生率,提高临床效果。

Objective To compare the clinical efficacy between trabeculectomy and laser peripheral iridectomy in the treatment of traumatic glaucoma.Methods This was a retrospective case control study.A total of 120 eyes of 120 patients with traumatic glaucoma admitted to Luoyang Boai Eye Hospital from Jan.2018 to Mar.2021 were divided into two groups:trabeculectomy with 60 cases as the observation group and laser peripheral iridectomy with 60 cases as the control group.The surgical results between the two groups were compared and analyzed.Results At 1 month after operation,the effective rate of the observation group was 98.33%(59/60),which was higher than the 86.67%(52/60)of the control group(χ^(2)=5.89,P=0.015).The visual acuity(logMAR)of the observation group was better than that of the control group(t=33.87,P<0.001)and the intraocular pressure was lower than that of the control group(t=22.03,P<0.001).The levels of Hcy,IL-6 and TNF-αin the observation group were all lower than those of the control group(all P<0.001).The incidence of adverse reactions of the observation group was 3.33%(2/60),which was lower than the 15.00%(9/60)of the control group(χ^(2)=4.90,P=0.027).Conclusion Compared with laser peripheral iridectomy,trabeculectomy improves the visual acuity of patients with traumatic glaucoma better,relieves intraocular pressure and inflammatory reaction,reduces the incidence of adverse reactions and achieves higher clinical efficacy.