两种植入物在非穿透性小梁手术中抗瘢痕化的临床观察

目的评价非穿透小梁手术中透明质酸钠生物胶和羊膜术后抗瘢痕化的作用。方法原发性开角型青光眼36例（60眼）随机分为A组和B组。A组非穿透性小梁手术联合透明质酸钠生物胶组18例（30眼），B组非穿透性小梁手术联合羊膜组18例（30眼），术后随访12～24个月。主要指标视力、眼压、结膜滤过泡、前房角、并发症。结果两组患者术后1周及术后6月最佳矫正视力比较，差异无统计学意义（F=0．647，0．735，P〉0．05）；术前两组眼压平均为（26．47±12．990）、（28．03±11．388）mmHg，差异无统计学意义（P〉0．05），术后1周、6月两组眼压均较术前降低（P〈0．05），术后1周1、6、12、24月平均眼压两组之间比较差异无统计学意义（F=0．01、0．093、1．104、0．788、0．039，P〉0．05）；术后1周、1月、6月、12月、24月滤过泡、手术成功率两组比较差异无统计学意义（P〉0．05）。结论非穿透小梁手术联合透明质酸钠生物胶和羊膜均可抑制术后瘢痕的形成，有效降低原发性开角型青光眼的眼压，两者疗效相当，但羊膜价格低廉、取材方便。

The anti-scar effect of two implants in the nonpenetrating trabecular surgery

Objective To evaluate the clinical results of antiscar effect of reticulated hyaluronic acid and amniotic membrane implant in nonperforating trabecular surgery （NPTS） for primary open angle glaucoma （POAG）. Methods Thirty-six cased （60 eyes） were divided into group A and group B,group A with 18 cases （30 eyes） underwent NPTS with reticulated hyaluronic acid implant-ation,group B with 18 cases （30 eyes） underwent NPTS with amniotic memberane implantation. The follow-up period was 12-24 months. Visual acuity, intraocular pressure （IOP） , filtering blebs and complications were observed. Results The best-corrected visual acuity had no significant difference between the two groups at 1 week,6 months after operation （ F = 0. 647,0. 735, P 〉 0. 05, respectively）. There was no difference in preoperative lOP between the two group （ P 〉 0. 05 ）. But the difference was significant between the two groups in postoperative IOP （ P 〉 0.05 ）. The IOP, filtering blebs and success rate have no significant difference between the two groups at 1w, 1m,6m, 12m and 24m after operation （ P 〉 0.05 ）. Conclusion The elevated IOP in patients with open angle gloucoma can be effectively reduced by NPTS with reticulated hyaluronic acid or with amniotic membrane implant, But the later one is convenient and econmic.