羊膜移植联合低浓度丝裂霉素C治疗原发性青光眼比较观察

目的：对比观察羊膜移植联合低浓度丝裂霉素C在治疗原发性青光眼中的临床效果。方法：对33例48眼原发性急性闭角型青光眼患者分为两组,联合组和单纯组,联合组采取低浓度丝裂霉素联合羊膜移植、小梁切除术治疗,单纯组用较高浓度丝裂霉素、小梁切除术,术后观察眼压、视力、滤过泡及并发症。结果：联合组视力提高较单纯组视力提高明显,且有显著性差异（P〈0.05）;术后3个月随访时,单纯组眼压控制较联合组低,且差异有显著性（P〈0.05）;联合组功能性滤过泡（87.5%）较单纯组（70.83%）高,并发症较单纯组少。结论：羊膜移植联合低浓度丝裂霉素治疗原发性青光眼具有眼压控制满意,并发症少等优点。

A Clinical Comparative Study of Amniotic Membrane Transplation Combined Mitomycin C Applied in Primary Glaucoma

Objective：To study the clinical effect of trabeculectomy combined with amniotic membrane transplation and mitomycin C in primary glaucoma.Methods：Thirty-three cases （48 eyes）with primary glaucoma were randomized into two groups：thecombined group underwent trabeculectomy combined with amniotic membrane transplation and mitomycin;the single group with traditional trabeculectomy and mitomycin C.The intraocular pressuer （IOP）,visual acuity,filtering blebs were measured and compared between the two groups after operation.Results：The decrease of visual acuity was seen in 10 eyes（41.7%）of the single group,whereas only 2 eyes （8.7%） in combined group,the difference between the two groups was significantly（P〈0.05）.In the early stage of postoperation,the IOP in two groups has no difference,three months later,the IOP in single group was lower than that of the combined group,the difference was significant （P〈0.05）.The percentage of functioning blebs in combined group was 87.5%,and that in the single group was 70.83%.Complications involving shallow anterior chamber,bleb leaking,persistant hypotony,macular edema was less in combined group than that in single group.Conclusions：Amniotic membrane transplation combined low dose mitomycin C can effectively control IOP and maintain the functional bleb,and has less complications,it is worthy of application in glaucoma surgical operation.