可调整巩膜瓣缝线法小梁切除术的临床应用

Clinical effect of adjustable sutured scleral flap of trabeculectomy

目的 观察可调整巩膜瓣缝线法小梁切除术的临床应用效果和并发症。方法 自 1999年开始 ,陆续随机地在部分抗青光眼手术患者中 ,使用可调整巩膜瓣缝线法小梁切除术 ,术后 6个月内对其视力、眼压、前房、滤过泡及并发症进行了密切的观测 ,截止到 2 0 0 2年 3月共获得 41例 ( 44只眼 )患者的临床资料 ,以此为治疗组。以同期的常规小梁切除术为对照组 ,作统计学分析。结果 治疗组术后第一天 ,3 5 %患眼视力保持不变和增进 ,眼压均值为 2 .0 2± 0 .73 k Pa( 1k Pa=7.5 mm Hg) ,未见有浅前房和并发症发生 ;术后 6个月 90 %患眼视力保持不变和增进 ,眼压均值为 1.96± 0 .5 2 k Pa,并形成功能性滤过泡。结论 可调整巩膜瓣缝线法小梁切除术较传统的小梁切除术可使前房尽早形成、视力尽快恢复、且减少术后炎症反应和并发症 ;并能够使眼压得到有效地控制 。

Objective To evaluate the clinical effect and complications of trabeculectomy with adjustable sutured scleral flap.Methods since 1999,randomly and continiously partly trabeculectomy with adjustable sutured scleral flap were used in the patients with glaucoma.After 6 months,visual acuity,intraocular pressure(IOP),anterior chamber depth,conjunctival blebs of filtration,and complications were observed and compared.44 eyes (41 patients) underwent trabeculectomy with adjustable sutured scleral flap were done,and was compared with control group.Results On the first postoperative day,vision of 35% eyes in the study group kept the same or better vision than the preoperative,with a mean IOP(2.02±0.43) kPa(1kPa=7.5mmHg);there was no shallow anterior chamber and complications.On six months after trabeculectomy,vision of 90% eyes in the study group kept the same or better vision than the preoperative,with a mean IOP(1.96±0.52)kPa;all of the functional conjunctival blebs of filtration was formed.Conclusions Trabeculectomy with adjustable sutured scleral flap is helpful to the reformation of the anterior chamber,improvement of visual acuity,decrease of the occurrence of postoperative complications,and been to control of the IOP,and formation of a functional conjunctival filtration blebs.