青光眼引流钉植入术治疗难治性开角型青光眼的疗效

发布时间：2018-08-15 16:49

【摘要】：目的:观察青光眼引流钉植入术治疗难治性青光眼的疗效。方法:对联合应用抗青光眼药物无法控制的难治性开角型青光眼19例19只眼行青光眼引流钉植入术,术中应用丝裂霉素(2 mg/6~8 mL,2.5~4 min)及可松解缝线。术后1天、2周和1、3、6、12个月进行随访,观察眼压、视力、滤过泡形态、前房深度、眼底C/D、降眼压药物使用情况、完全及部分成功率及有无并发症等情况。结果:19例患者中,术后完全成功率78.9%(15例),部分成功率10.5%(2例),失败10.5%(2例)。术前用3~5种降眼压药,眼压控制于27.7±10.1 mmHg。术后随访仅三人需使用1~2种降压药物。眼压下降组间有显著性意义(P0.001)。与术前相比,术后1天(11.8±7.7 mmHg,P0.001),术后2周(10.1±4.2 mmHg,P0.05),1个月(12.0±4.0 mmHg,P=0.001),6个月(12.2±3.4 mmHg,P0.001),1年(13.1±3.3 mmHg,P=0.001)及2年随访(14.5±2.5 mmHg,P=0.001),眼压下降均具有显著性意义。术后患者视力、前房深度及C/D改变差异无显著性意义。末次随访滤过泡弥散隆起57.9%(11例),微囊型15.8%(3例),瘢痕型21.1%(4例),包裹型5.3%(1例)。所有患者均未观察到明显的术后并发症的发生。结论:房水引流钉植入术治疗难治性开角型青光眼手术成功率高,并发症少,值得推广。
[Abstract]:Objective: to observe the effect of glaucoma drainage nail implantation on refractory glaucoma. Methods: 19 eyes of 19 patients with refractory open-angle glaucoma who could not be controlled by anti-glaucoma drugs were treated with glaucoma drainage nail implantation. Mitomycin (2 mg/6~8 mL) and decomposable suture were used during the operation. Intraocular pressure (IOP), visual acuity, bleb morphology, anterior chamber depth, fundus C / D, use of intraocular pressure lowering drugs, complete and partial success rate and whether there were complications were observed. Results among 19 cases, the complete success rate was 78.9% (15 cases), the partial success rate was 10.5% (2 cases), and the failure rate was 10.5% (2 cases). The intraocular pressure was controlled at 27.7 卤10.1 mm Hg. Only three patients were followed up with 1 or 2 antihypertensive drugs. There was significant difference between the two groups (P 0.001). Compared with before operation, intraocular pressure decreased significantly at 1 day (11.8 卤7.7 mm HgP 0.001), 2 weeks after operation (10.1 卤4.2 mm HgP 0.05), 1 month (12.0 卤4.0 mm HgG P0.001), 6 months (12.2 卤3.4 mm HgP0.001), 1 year (13.1 卤3.3 mmHgP0.001) and 2 years follow-up (14.5 卤2.5 mmHgGG P0.001). There was no significant difference in visual acuity, anterior chamber depth and C / D changes after operation. At the last follow-up, 57.9% (11 cases) of diffusion bulge, 15.8% (3 cases) of microencapsulation, 21.1% (4 cases) of scar, 5.3% (1 case) of encapsulation. No obvious postoperative complications were observed in all patients. Conclusion: aqueous humor drainage nail implantation in the treatment of refractory open angle glaucoma has a high success rate and few complications, so it is worth popularizing.
【作者单位】：中山大学中山眼科中心眼科学国家重点实验室;
【基金】：广东省自然科学基金项目(S2013010015780) 国家自然科学基金项目(81570846)~~
【分类号】：R779.6

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