巩膜隧道切口小梁切除术对闭角型青光眼患者前房角结构及术后并发症的影响

Effect of Trabeculectomy with Scleral Tunnel Incision on Anterior Chamber Angle Structure and Postoperative Complications of Patients with Angle-Closure Glaucoma

目的:探究巩膜隧道切口小梁切除术在闭角型青光眼患者中的应用效果。方法:回顾性分析2021年6月—2023年6月解放军联勤保障部队第964医院眼科诊治的86例单眼发病闭角型青光眼患者资料。根据手术方式的不同分为研究组与对照组,各43例。研究组采用巩膜隧道切口小梁切除术,对照组采用常规小梁切除术。比较两组眼压与视力、前房角结构、并发症发生情况。结果:术后6个月,两组眼压均较术前降低,且研究组低于对照组,两组视力均较术前升高,且研究组高于对照组,差异均有统计学意义(P<0.05)。术后6个月,两组前房角开放距离500、中央前房深度较术前升高,且研究组均高于对照组,虹膜晶状体接触距离较术前缩短,且研究组短于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率为9.30%,低于对照组的25.58%,差异有统计学意义(P<0.05)。结论:巩膜隧道切口小梁切除术可降低闭角型青光眼患者眼压,提高视力水平,改善前房角结构,降低术后并发症发生风险。

Objective:To investigate the effect of trabeculectomy with scleral tunnel incision in patients with angle-closure glaucoma.Methods:The data of 86 patients with monocular angle-closure glaucoma treated in Department of Ophthalmology,Chinese People’s Liberation Army Joint Logistics Support Force 964th Hospital,from June 2021 to June 2023 were retrospectively analyzed.The patients were divided into study group and control group according to different surgical methods,whit 43 cases.Trabeculectomy with scleral tunnel incision was performed in the study group,and conventional trabeculectomy was performed in the control group.The intraocular pressure,visual acuity,anterior chamber Angle structure and complications were compared between the two groups.Results:Six months after surgery,the intraocular pressure of both groups was lower than before surgery,and the study group was lower than the control group,and the visual acuity of both groups was higher than before surgery,and the study group was higher than the control group,the differences were statistically significant(P<0.05).Six months after surgery,the anterior chamber angle opening distance of 500 and the central anterior chamber depth of both groups were higher than before surgery,and the iris lens contact distance of the study group was shorter than before surgery,and the study group was shorter than the control group,the differences were statistically significant(P<0.05).The incidence of complications in the study group was 9.30%,which was lower than 25.58%in the control group,the difference was statistically significant(P<0.05).Conclusion:Trabeculectomy with scleral tunnel incision can reduce IOP,improve visual acuity level,improve anterior chamber Angle structure and reduce the risk of postoperative complications.