滤过手术联合羊膜植入物治疗青光眼的临床观察

The Clinical Observation of Filtering Surgery with Amniotic Membrane Implant for Treatment of Glaucoma

目的 观察滤过手术联合羊膜植入物对难治性青光眼的临床疗效。方法 对 32例 (39眼 )难治性青光眼随机配对分为滤过手术联合羊膜植入物组 (实验组 ,2 1眼 )和单纯行滤过手术组 (对照组 ,18眼 )进行疗效观察。术后观察视力、视野、眼压、眼内反应及滤过泡。随访时间平均为 1年。结果 ①视力、视野 :两组术后与术前均无明显改变。②功能滤过泡数 :实验组 15眼 (71% ) ,对照组 8眼 (44 % ) ,两组比较差异有显著性 (P <0 .0 5 )。③眼压 :术后 3月、6月、9月、12月实验组与对照组眼压分别为 2 .2 1± 0 .32kPa ,2 .2 7± 0 .2 9kPa ,2 .5 0± 0 .84kPa ,2 .19± 0 .83kPa和 2 .38± 0 .37kPa ,2 .71± 0 .80kPa ,2 .99± 0 .64kPa ,2 .89± 1.0 0kPa ;其中术后 3月时两组眼压相比差异无显著性 (P >0 .0 5 ) ,6月、9月、12月时两组眼压相比差异有显著性 (P <0 .0 5 )。④手术成功率 :实验组 86% ,对照组 5 6% ,相比有显著性差异 (P <0 .0 5 )。结论 滤过手术联合羊膜植入物能显著手术提高成功率 ,有效降低眼压 ,且作用持久 ,无明显并发症 。

Objective To observe the clinical effect of filtering surgery with amniotic membrane implant on uncontrolled glaucoma.Methods 32 patients (39 eyes) with uncontrolled glaucoma were subgrouped randomly into filtering surgery with amniotic membrane implant group (the tested group,21 eyes) and simple filtering surgery group (the contrasted group,18 eyes).The vision,visual field,intraocular pressure (IOP),intraocular reactions and the filtering blebs appearance were observed and recorded.The average follow-up was one year.Results ①Vision and visual field:Two groups remained stable between preoperation and postoperation.②The functional filtering blebs:the tested group was 15/21 (71%) and the contrasted 8/18 (44%),P<0.05.③IOP:The IOP at three months,six months,nine months and twelve months intervals after surgery were 2.21±0.32kPa,2.27±0.29kPa,2.50±0.84kPa,2.19±0.83kPa and 2.38±0.37kPa,2.71±0.80kPa,2.99±0.64kPa,2.89±1.00kPain contrasted group.④ The successful rates:The tested group was 86% and the contrasted 56%,P<0.05.Conclusion The successful rate was elevated,the IOP was reduced effectively;the postoperative significant complications hardly existed and the effect was lasting in filtering surgery with amniotic membrane implant,but a follow-up study should be conducted to confirm the long-term results.