非穿透性小梁手术联合透明质酸钠生物胶植入术治疗开角型青光眼

Nonperforating trabecular surgery with reticulated sodium hyaluronic acid implant for treatment of primary open-angle glaucoma

  • 摘要: 目的: 观察非穿透性小梁手术联合透明质酸钠生物胶植入术治疗开角型青光眼的临床疗效。方法: 对13例16眼开角型青光眼中、晚期患者行非穿透性小梁手术联合透明质酸钠生物胶植入术。术后观察视力、眼内反应、滤过泡和眼压。结果: 术后1周内视力不变11只眼,视力提高1只眼,视力下降4眼。两周后视力提高者3眼,其余视力均保持术前水平。术后14只眼无任何眼内反应,2只眼前房有轻度闪光,术后5d消失。所有病例均在术后1~2d形成弥散隆起滤过泡,仅有2例最后观察为扁平滤过泡。除2眼术后随访眼压偏高3.00kPa,局部用药后眼压正常。余14眼眼压均在2.67kPa以下。术后1d平均眼压(1.18±0.4 8) kPa,与术前眼压(3.19±0.33) kPa比较,差异有非常显著性(t=13.67,P<0.001)。术后1周平均眼压(1.4 7±0.50) kPa,与术前眼压(3.19±0.33kPa)比较,差异有非常显著性(t=11.33,P<0.001)。经3~12月随访,最后随访眼压2.00kPa左右。结论: 非穿透性小梁手术联合透明质酸钠生物胶植入术后降压效果满意,术后并发症少,安全,是一种治疗开角型青光眼的有效方法。

     

    Abstract: Objective: To evaluate the clinical effect of nonperforating trabecular surgery (NPTS) with reticulated sodium hyaluronic acid implant for treatment of primary open-angle glaucoma (POAG). Methods: Sixteen eyes of 13 patients with advanced POAG underwent NPTS with reticulated sodium hyaluronic acid implant. Postoperatively, vision acuity, inflammation reaction, filtering bleb and intraocular pressure (IOP) were analyzed. Results: Postoperatively, vision acuityunchanged in 11 eyes、enhanced in 1 eyes and decreased in 4 eyes, inflammation reaction absented in 14 eyes and temporary presented in 2 eyes only slightly flash point, filtering bleb presented in all cases, IOP decreased in 14 eyes from preoperative (3.19 ± 0.33)kPa to postoperative 1 day mean 1.18 ± 0.48kPa (t= 13.67, P< 0.001 ) and postoperative 1 week mean(1.47 ± 0.50)kPa (t= 11.33, P< 0.001 ), postoperative IOP slightly raised to 3.00kPa only 2 eyes, but after local drug treatment IOP was normal. After follow-up 3 ~ 12 months last IOPof all cases were about 2.00kPa. Conclusions: The elevated IOP of POAG can be effectively reduced by NPTS with reticulated sodium hyaluronic acid implant, and that the postoperative complications were singularly.

     

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