复合式小梁切除术治疗闭角型与开角型青光眼的对比研究

目的：比较研究复合式小梁切除术在闭角型青光眼(angle closure glaucoma, ACG )及开角型青光眼( open angle glaucoma,OAG)中的治疗效果。
　　方法：前瞻性研究。选择2014-07/2015-07的136例136眼青光眼患者为研究对象,根据青光眼类型分为 ACG 组72例72眼与 OAG 组64例64眼,均给予复合式小梁切除术,比较两组患者术后眼压、浅前房、功能性滤泡以及并发症情况。
　　结果：术后1、3mo,两组眼压均明显下降,ACG 组患者眼压明显低于 OAG 组(t =11.037、12.660, P<0.05)；术后3mo时,ACG 组患者眼压控制率98.6%明显高于 OAG 组89.1%(χ2=5.580, P <0.05)；ACG 组浅前房总发生率11.1%明显低于 OAG 组25.0%(χ2=4.497,P <0.05)；ACG 组功能性滤泡形成率62.5%明显高于 OAG 组43.5%(χ2=4.035,P<0.05)；两组并发症发生率比较无统计学意义(5.6% vs 7.8%,P=0.475>0.05)。
　　结论：复合式小梁切除术有助于降低 ACG、OAG 型青光眼患者眼压,安全性高,且 ACG 型青光眼的治疗效果优于OAG 型青光眼。

Comparison of compound trabeculectomy for angle-closure and open angle glaucoma

AIM: To compared therapeutic effect of compound trabeculectomy in treatment of angle - closure and open angle glaucoma.
METHODS: A total of 136 patients ( 136 eyes) with glaucoma from July 2014 to July 2015 were divided into angle-closure glaucoma (ACG) group with 72 cases (72 eyes) and open angle glaucoma ( OAG) group with 64 cases (64 eyes). All the patients were given compound trabeculectomy. The intraocular pressure, shallow anterior chamber, functional follicular and complications were compared between two groups after operation.
RESULTS: The intraocular pressure of all patients were significantly decreased at 1 and 3mo after surgery. The intraocular pressure of ACG group were significantly lower than that of OAG group ( t = 11. 037, 12. 660, P <0. 05). The intraocular pressure control rate of ACG group (98. 6%) was significantly higher than that of OAG group (89. 1%) (χ2 = 5. 580, P<0. 05) at 3mo after surgery. The shallow anterior chamber total incidence of ACG group was 11. 1%. It was significantly lower than OAG group (25. 0%) ( χ2 = 4. 497, P < 0. 05). The functional follicular formation rate of ACG group was 62. 5%. It was significantly higher than OAG group (43. 5%) (χ2 = 4. 035, P < 0. 05 ). There were no statistically significant on complications between two groups (5. 6% vs 7. 8%, P =0. 475).
CONCLUSION: Compound trabeculectomy can reduce intraocular pressure of ACG and OAG patients safely. The results in ACG patients is better than that in OAG patients.