复合式小梁切除术治疗闭角型与开角型青光眼的对比研究

谢海娟



·临床报告·

复合式小梁切除术治疗闭角型与开角型青光眼的对比研究

谢海娟

Department of Ophthalmology, People’s Hospital of Baoji, Baoji 721000, Shaanxi Province, China

•METHODS: A total of 136 patients (136 eyes) with glaucoma from July 2014 to July 2015 were divided into angle-closure glaucoma (ACG) group with 72 cases (72 eyes) and open angle glaucoma (OAG) group with 64 cases (64 eyes). All the patients were given compound trabeculectomy. The intraocular pressure, shallow anterior chamber, functional follicular and complications were compared between two groups after operation.

•RESULTS: The intraocular pressure of all patients were significantly decreased at 1 and 3mo after surgery. The intraocular pressure of ACG group were significantly lower than that of OAG group (t=11.037, 12.660,P<0.05). The intraocular pressure control rate of ACG group (98.6%) was significantly higher than that of OAG group (89.1%) (χ2=5.580,P<0.05) at 3mo after surgery. The shallow anterior chamber total incidence of ACG group was 11.1%. It was significantly lower than OAG group (25.0%) (χ2=4.497,P<0.05). The functional follicular formation rate of ACG group was 62.5%. It was significantly higher than OAG group (43.5%) (χ2=4.035,P<0.05). There were no statistically significant on complications between two groups (5.6%vs7.8%,P=0.475).

•CONCLUSION: Compound trabeculectomy can reduce intraocular pressure of ACG and OAG patients safely. The results in ACG patients is better than that in OAG patients.

目的：比较研究复合式小梁切除术在闭角型青光眼(angle closure glaucoma，ACG)及开角型青光眼(open angle glaucoma，OAG)中的治疗效果。

方法：前瞻性研究。选择2014-07/2015-07的136例136眼青光眼患者为研究对象，根据青光眼类型分为ACG组72例72眼与OAG组64例64眼，均给予复合式小梁切除术，比较两组患者术后眼压、浅前房、功能性滤泡以及并发症情况。

结果：术后1、3mo，两组眼压均明显下降，ACG 组患者眼压明显低于OAG组(t=11.037、12.660,P<0.05)；术后3mo时，ACG组患者眼压控制率98.6%明显高于OAG组89.1%(χ2=5.580,P<0.05)；ACG组浅前房总发生率11.1%明显低于OAG组25.0%(χ2=4.497，P<0.05)；ACG组功能性滤泡形成率62.5%明显高于OAG组43.5%(χ2=4.035，P<0.05)；两组并发症发生率比较无统计学意义(5.6%vs7.8%，P=0.475>0.05)。

结论：复合式小梁切除术有助于降低ACG、OAG型青光眼患者眼压，安全性高，且ACG型青光眼的治疗效果优于OAG型青光眼。

闭角型青光眼；开角型青光眼；复合式小梁切除术；眼压

引用：谢海娟.复合式小梁切除术治疗闭角型与开角型青光眼的对比研究.国际眼科杂志2016;16(7):1353-1355

0引言

青光眼是临床中常见的由持续性高眼压导致的视神经萎缩和特征性视野缺损，其引起的视神经损伤是不可逆的，是一种终身性眼部疾病，对患者视力危害巨大，严重的甚至导致失明[1]。目前，对于青光眼治疗的最有效的办法是利用手术来降低眼压，常用的为小梁切除手术，但传统的小梁切除手术在术后会出现浅前房、脉络膜脱离、滤过泡粘连等一系列并发症，影响了术后的恢复以及手术的成功率[2]。近几年来，随着医疗手段的进步以及对青光眼认识水平的深入，复合式小梁手术由于其具有术后恢复快、并发症少以及成功率高等特点，逐渐开始取代传统的小梁切除术[3]。……