非穿透小梁手术联合不同植入物的临床研究

Non-Perforating Trabecular Surgery With Different Implants

目的 :探讨非穿透小梁切除术 (NPTS)联合不同植入物的方法及疗效。方法 :将 34例 ( 4 8)眼原发开角型青光眼随机分为A、B、C组 ,每组均为 16眼。A :NPTS +HealonGV植入。B :NPTS +保存羊膜植入。C :NPTS +透明质酸钠生物胶 (SKGEL)。所有眼联合MMC及调整缝线 ,观察术后眼压、视力、滤过泡、前房等。结果 :随访一年 ,手术成功率 :A组 5 6 3 % ,B组 87 5 % ,C组 93 8% ,B、C两组同A组对比有显著差异 ( χ2 =3 86。P <0 0 5 ,χ2 =6 ,P <0 0 2 5 )而B、C两组无显著差异 ( χ2 =0 38,P >0 5 )所有患者无前房变浅、炎症、脉络膜脱离、视力下降等并发症。结论 :NPTS植入物可选择羊膜及SKGEL ,而不选择HealonGV ,但羊膜更经济。

Objective:To evaluate the techniques and results of non-perforating trabecular surgery(NPTS)with different implants. Methods:NPTS was performed on 34 cases of primary open angle glaucoma(48 eyes)that were randomly divided into three groups by each 16 eyes with different implants,A group:Healon GV,B:amniotic membrane,and C:Reticulated hyaluronic acid.The postoperative intraocular pressure(IOP),intraocular reactions and the bleb status were recorded.Mean follow -up was 1 year. Results:The successful rates were 56,3%(in A group),87.5%(B group),and 93.8%(C group),respectively.There were significant differences in successful rates between B,C and A(P<0.05,P<0.025),but no difference between B and C(P>0.05).The complications such as flat chamber,inflammation and choroidal detachment were not observed,the visual acuity remain unchanged. Conclusions:Amniotic membrane and SK GEL can be used for NPTS implants but not Healon GV,however amniotic membrane was much cheap.