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目的 :研究和评价青光眼小梁切除术联合巩膜瓣松解缝线手术的临床效果。方法 :根据随机分配原则将各类青光眼分成治疗和对照两组 ,各 50例 ,两组在性别、平均年龄、青光眼分类和术前平均眼压方面差异无显著性 (P >0 0 5)。并将两组术后前房形成情况及深度的变化、术前及最后随访的眼压、术后滤过泡情况及手术并发症进行比较。结果 :治疗组术后第 1天无浅前房发生 ,第 3、4天出现浅 /无、Ⅱa、Ⅱb各 1例。对照组术后第 1天发生浅Ⅰ级 9例 ,术后 3～ 7天发生浅Ⅱ级 7例、浅Ⅲ级 5例。两组经统计学处理有显著性差异 (P <0 0 0 5)。治疗组术前眼压平均为 4 82± 1 53kPa ,最后随访眼压平均为 1 94± 0 2 3kPa。眼压在 2 74kPa以下者 4 3只眼 ,占 86%。对照组术前眼压平均为 4 57± 1 64kPa,最后随访眼压平均为 2 3 1± 0 4 4kPa。眼压在 2 74kPa以下者 3 6只眼 ,占 72 %。治疗组术后功能性滤过泡占90 % ,对照组占 66% ,经统计学处理有显著性差异 (P <0 0 1 )。治疗组术后无晶体混浊加重发生 ,对照组发生 7例 ( 1 4 % )。结论 :青光眼小梁切除术联合巩膜瓣松解缝线手术 ,不仅能主动调整滤过功能 ,很好的控制眼压 ,而且能减少并发症的发生 ,从而大大提高抗青光眼的手术疗效。
Objective: To study and evaluate the clinical effect of glaucoma trabeculectomy combined with scleral loosening suture operation. Methods: All kinds of glaucoma were divided into treatment and control groups according to the principle of random distribution. Each group had 50 cases. There was no significant difference in gender, average age, glaucoma classification and preoperative average intraocular pressure between the two groups (P> 0.05). The changes of postoperative anterior chamber formation and depth, intraocular pressure (IOP) before and after the last follow-up, postoperative bleb filtration and surgical complications were compared. Results: There was no shallow anterior chamber on the first postoperative day in the treatment group, light / no on the third and fourth days, and one case of Ⅱa and Ⅱb respectively. In the control group, 9 cases of superficial Ⅰ grade occurred on the first postoperative day and 7 cases of superficial Ⅱ grade and 5 cases of superficial Ⅲ grade occurred 3-7 days after operation. There was a significant difference between the two groups by statistical analysis (P <0 0 05). The mean preoperative IOP in the treatment group was 4 82 ± 1 53 kPa and the mean IOP at the final follow-up was 1 94 ± 0 2 3 kPa. Intraocular pressure in 2 74kPa following 43 eyes, accounting for 86%. The average preoperative IOP in the control group was 4 57 ± 1 64 kPa and the mean IOP at the final follow-up was 2 31 4 0 4 4 kPa. Intraocular pressure in 2 74kPa the following 36 eyes, accounting for 72%. Functional filtration was 90% in the treatment group and 66% in the control group, which was significantly different after statistical analysis (P <0.01). In the treatment group, there was no aggravation of opacity and the control group occurred in 7 cases (14%). Conclusion: Glaucoma trabeculectomy combined with scleral loosening suture operation can not only take the initiative to adjust the filtration function, but also control the intraocular pressure well and reduce the incidence of complications, thereby greatly improving the anti-glaucoma surgical treatment.