青光眼小梁切除术中羊膜应用的临床观察

目的观察小梁切除术中羊膜应用对青光眼的治疗效果.方法对20例20只眼晚期青光眼及难治性青光眼采用常规小梁切除术并于巩膜板层间植入羊膜片,观察术后的临床效果及并发症.结果术后6个月眼压控制率95%(1例发育性青光眼需加用药物控制),1例年轻的新生血管性青光眼患者未能控制眼压.术后视力85%稳定或稍改善,15%稍下降.浅前房发生率10%,滤过泡较厚实弥散、充血期较长,但有滤过功能.未见慢性感染、眼内炎等严重并发症发生.结论羊膜用于小梁切除术中安全有效,对于新生血管性青光眼效果差.其作用机制、羊膜制备方法优化等方面有待进一步研究.

Effects of amnion used in trabeculectomy for advanced glaucoma and refractory glaucoma

Objective:To observe the curative effects of trabeculectomy combining amnion implant to glaucoma.Methods:Trabeculectomy was employed in20eyes of20cases with advanced glaucoma or refractory glaucoma,and amnion was implanted under the flap of sclera.The curative effects and complications of post-operation were ob-served.Results:Intraocular pressure was controlled in95%of the cases in6months postoperatively(one case with juvenile glaucoma was needed drugs to control intraocular pressure).The intraocular pressure of a young man with neovascular glaucoma couldn' t be controlled.The visual acuity was stable in85%of the cases and little declined in15%of those postoperatively.The occurrence ratio of shallow anterior chamber was10%.The filter bubbles of all cases were dispersive;the periods of congestion were longer.But all of them had kept filter function.Neither chronic infection nor endophthalmitis happened.Conclusions:It is safe and efficient that amnion is used in trabeculectomy,but no satisfactory in neovascular glaucoma.Further study is necessory on function mechanism and improvement of amnion-prepared methods.