非穿透小梁手术联合羊膜植入治疗继发性开角型青光眼

The combination of non-perforating trabecular surgery and amniotic membrane implantation in the treatment of secondary open-angle glaucoma

目的 评价非穿透小梁手术联合羊膜植入治疗继发性开角型青光眼的临床效果。方法 16例(16眼)继发性开角型青光眼,行非穿透小梁手术联合羊膜植入术。术后观察眼压、滤过泡、眼内反应及视力等情况。随访6～24个月。结果 术后1、3、6、12和24个月的眼压(单位:mmHg)分别为:13.52±4.71、16.30±4.11、16.38±4.26、16.54±4.39和17.6±4.58,与术前眼压46.24±9.32相比,差异有非常显著性(P<0.01)。随访期间2眼眼压>21mmHg,其中一眼局部用药可控制,另一眼接受再次手术。75％眼可见显著弥散的滤过泡。无手术并发症发生。术后早期视力不稳定,1个月后有不同程度提高。结论 非穿透小梁手术联合羊膜植入治疗继发性开角型青光眼是一种理想的方法,比经典小梁切除术更优越。

Objective To evaluate the effectiveness of non-perforating trabecular surgery ( NPTS) combination with amniotic membrane implantation on treatment of secondary open-angle glaucoma. Methods NPTS with amniotic membrane implantation was performed on 16 eyes of 16 patients with secondary open-angle glaucoma. Postoperatively, the IOP, intraocular reaction, bleb appearance, complications and visual acuity were observed. The follow-up period ranged from 6 to 24 months. Results The mean IOP was 13.52 +4.71,16.30 +4. 11,16.38+4.26,16.54 +4.39 and 17.6 +4. 58mmHg at month 1,3,6 , 12 and 24 postoperatively. There was a statistically significant difference between mean preoperative IOP(46. 24 +9. 32mmHg) and postoperative IOP (P < 0. 01). During follow-up,the IOP was > 21mmHg in 2 eyes. One of them could be controlled with topical medicine and the others had to undergo further operation. 75% of eyes had obvious diffuse blebs. Minimal complications were observed. The visual acuities were improved 1 month later after surgery. Conclusion NPTS combined with amniotic membrane implantation may be valuable as a initial surgery in patients with secondary open-angle glaucoma.