可调节缝线在慢性闭角型青光眼复合式小梁切除术中的应用

目的:观察可调节缝线方法在慢性闭角型青光眼复合式小梁切除术中应用的临床效果。方法:选择诊断为慢性闭角型青光眼的患者87例103眼,随机分为A、B两组。A组患者(54眼)在复合式小梁切除术(术中联合使用丝裂霉素C)的基础上,加用巩膜瓣可调节缝线;B组患者(49眼)单纯行复合式小梁切除术。术后随访6¹2个月,观察患者术后眼压、滤过泡形态、前房深度以及患者住院天数等情况。结果:A组患者术后6个月眼压平均(14.7±0.8)mm Hg,B组患者为(12.9±0.9)mm Hg,两组患者比较无显著性差异(P>0.05)。A组患者术后功能性滤过泡45人(83.33%),B组患者39人(79.59%),两组患者比较无显著性差异(P>0.05)。A组患者术后无浅前房发生,B组患者8人(20.41%)发生浅前房,两组患者比较有显著性差异(P<0.05)。A组患者平均住院时间(7.6±2.1)d,B组患者(12.1±3.7)d,两组患者比较有显著性差异(P<0.05)。结论:在慢性闭角型青光眼复合式小梁切除手术中应用可调节缝线技术,可以降低术后浅前房的发生率,缩短患者的住院天数,且对患者术后眼压、功能性滤过泡的形成无影响。

Application of adjustable suture in complex trabeculectomy for patients with chronic angle-closure glaucoma

Objective：To observe the clinical effects of adjustable suture in complex trabeculectomy for patients with chronic angle-closure glaucoma. Methods： This random control study included 87 cases （103 eyes） with chronic angle-closure glaucoma. They were randomly divided into a group with complex trabeculectomy （ using mitomycin C in the operation） combined with adjustable suture （group A, 54 eyes） and a group with complex trabeculectomy （group B, 49 eyes）. The post-operative followed-up periods ranged from 6-12 months. Post-operative intraocular pressure, bleb morphology, the depth of anterior chamber （ AC） , and days in the hospital were observed. Results：The intraocular pressure of group A and group B after the operation were （14. 7±0. 8）mmHg and （12. 9 ±0. 9）mmHg, and there was no significant difference between the two groups （P〉0. 05）. The functional bleb rate were 83. 33% （45 of 54 eyes ） in group A and 79. 59% （39 of 49 eyes） in group B, and no statistical significance was found between the two groups （P〉0. 05）. 8 eyes （20. 41%） developed postoperative shallow AC in group B and 0 cases in group A （P〈0. 05）. The days staying in the hospital of group A （7. 6±2. 1）d was less than that of group B （12. 1±3. 7）d （P〈0. 05）. Conclusions：The adjustable suture in complex trabeculectomy for the patients with chronic angle-closure glaucoma can reduce the incidence of shallow and flat chamber after trabeculectomy, shorten the days staying in the hospital, and have no effect on the post-operative intraocular pressure and bleb morphology.