巩膜池复合小梁切除术联合湿态羊膜移植治疗闭角型青光眼的疗效及其对眼压、视力及滤过泡形成的影响分析

Effect of scleral cisterna combined trabeculectomy with wet amniotic membrane transplantation on angle-closure glaucoma and its influence on iOP,visual acuity and follicular formation

目的探讨巩膜池复合小梁切除术联合湿态羊膜移植治疗原发性闭角型青光眼的疗效及其对眼压、视力及滤过泡形成的影响分析。方法将我院2020年5月至2023年3月期间153例原发性闭角型青光眼患者作为研究对象,根据随机数字表法分为两组,传统组77例予以常规小梁切除术,联合组76例予以巩膜池复合小梁切除术联合湿态羊膜移植治疗,对比两组患者临床疗效、眼压、视力、滤过泡形成(随访3个月)、手术失败率、不良反应的发生情况。结果本研究中治疗后,联合组病例脱落3例,传统组病例脱落4例,联合组总有效率95.89%(70/73)高于传统组86.30%(63/73)(χ^(2)=4.137,P=0.042);治疗后3个月,联合组BCVA的表达(0.51±0.21)logMAR低于传统组(0.63±0.14)logMAR(t=3.334,P=0.002),联合组眼压值(12.75±1.19)mmHg低于传统组(13.12±1.28)mmHg(t=2.241,P=0.029);两组均有效控制滤过道瘢痕化,且联合组的滤过泡形成情况的优于传统组(Z=8.279,P=0.041);联合组手术失败率(5.48%)低于传统组(19.18%)(χ^(2)=6.431,P=0.011),联合组不良反应发生率(5.48%)低于传统组(16.44%)(χ^(2)=4.722,P=0.029)。结论巩膜池复合小梁切除术联合湿态羊膜移植治疗能够有效控制眼压,减少滤过泡的疤痕化,减少不良反应的发生,提高手术成功率。

Objective Exploring the efficacy of scleral pool combined with trabeculectomy and wet amniotic membrane transplantation in the treatment of primary angle closure glaucoma,and analyzing its impact on intraocular pressure,vision,and follicular formation.Methods A total of 153 patients with primary angle-closure glaucoma in our hospital from May 2020 to March 2023 were divided into two groups according to random number table method:77 patients in the traditional group received conventional trabeculectomy,and 76 patients in the combined group received scleral cisterna complex trabeculectomy combined with wet amniotic membrane transplantation.The clinical efficacy,intraocular pressure,visual acuity,follicular formation(follow-up for 3 months),surgical failure rate and the occurrence of adverse reactions were compared between the two groups.Results After treatment,3 cases were shed in the combined group and 4 cases in the traditional group.The total effective rate of the combined group was 95.89%(70/73)higher than that of the traditional group 86.30%(63/73)(χ^(2)=4.137,P=0.042);At 3 months after treatment,the expression of BCVA(0.51±0.21)logMAR in the combined group was lower than that in the traditional group(0.63±0.14)logMAR(t=3.334,P=0.002),The IOP value of the combined group(12.75±1.19)mmHg was lower than that of the traditional group(13.12±1.28)mmHg(t=2.241,P=0.029);Both groups effectively controlled the scarring of the filter passages,and the formation of filter bubbles in the combined group was better than that in the traditional group(Z=8.279,P=0.041);The failure rate of the combined group(5.48%)was lower than that of the traditional group(19.18%)(χ^(2)=6.431,P=0.011),and the incidence of adverse reactions in the combined group(5.48%)was lower than that of the traditional group(16.44%)(χ^(2)=4.722,P=0.029).Conclusion Scleral cisterna complex trabeculectomy combined with wet amniotic membrane transplantation can effectively control the intraocular pressure,reduce the scarring of the filter bubble,reduce the occurrence of adverse reactions,and improve the success rate of surgery.