巩膜隧道刀制作巩膜瓣在青光眼滤过手术中的应用

目的探讨巩膜隧道刀制作巩膜瓣在青光眼滤过手术中的应用价值。方法将86例106眼青光眼患者随机分为两组：巩膜隧道刀制作巩膜瓣组46例50眼;传统胡须刀片制作巩膜瓣组40例56眼。比较两组术中巩膜瓣制作时间、巩膜瓣异常情况发生率及术后眼压和滤过泡情况。结果术中应用巩膜隧道刀制作巩膜瓣的时间较传统胡须刀片制作巩膜瓣的时间明显缩短（P〈0．01）。巩膜隧道刀制作巩膜瓣组与传统胡须刀片制作巩膜瓣组在术中巩膜瓣制作并发症上比较差异无统计学意义（P〉0．05）;术后随诊眼压巩膜隧道刀制作巩膜瓣组为（13．56±3．44）mmHg,传统胡须刀片制作巩膜瓣组为（14．35±4．25）mmHg,两组间差异无统计学意义（P〉0．05）;随诊功能性滤过泡巩膜隧道刀制作巩膜瓣组为92．0％,传统胡须刀片制作巩膜瓣组为78．6％,巩膜隧道刀制作巩膜瓣组与传统胡须刀片制作巩膜瓣组比较差异有统计学意义（P〈0．05）。结论采用巩膜隧道刀制作巩膜瓣与传统胡须刀片制作巩膜瓣相比省时、省力、对巩膜瓣损伤小,巩膜瓣、巩膜床光滑平整,术后反应轻,术后能理想地控制眼压,有利于形成功能性滤过泡。

The clinical effect of sclera tunnel knife making sclera flap in glaucoma filtration operation

Objective To evaluate the clinical effect of the sclera tunnel knife making sclera flap in glaucoma filtration operation.Methods Eighty-six cases 106 eyes with glaucoma patients were randomly divided into 2 groups:the sclera tun nel knife making sclera flap group in 46 cases 50 eyes;traditional beard blade making sclera flap group in 40 cases56 eyes.The two groups of intraoperative sclera flap scleral flap in time,abnormal rate and postoperative intraocular pressure and bleb was compared.Results After application of the sclera tunnel knife making sclera flap time compared with the tra ditional beard blade making sclera flap of the time was significantly shortened(P < 0.01).Sclera tunnel knife making sclera flap group and traditional beard blade making sclera flap groups in intraoperative sclera flap complications had no signif icant difference(P > 0.05);the follow-up of intraocular pressure sclera tunnel knife making sclera flap group was(13.56 ± 3.44) mm Hg,traditional beard blade making sclera flap group was(14.35 ±4.25) mm Hg,the difference between the two groups were no significant(P > 0.05);follow-up functional filtering blebs with scleral tunnel knife making sclera flap group of 92.0% traditional beard blade making sclera flap group of 78.6%,sclera tunnel knife making sclera flap group and tra ditional beard blade making sclera flap groups was significant(P < 0.05).Conclusion The sclera tunnel knife making sclera flap and traditional beard blade making sclera flap compared with time saving,little damage to the scleral flap,scler al flap scleral bed,smooth,light reaction after,postoperative can ideally control intraocular pressure,it is conducive to the formation of functional filtering bleb.