青光眼小梁切除术后功能性滤过泡形态与眼表改变的关系

发布时间：2018-06-10 12:03

本文选题：青光眼 + TRABE　；参考：《中国老年学杂志》2014年22期

【摘要】：目的探讨青光眼小梁切除术(TRABE)后功能性滤过泡形态与眼表改变的关系。方法选择2012年6月至2013年6月该院行TRABE治疗的86例青光眼患者,根据术后眼表改变情况分组,其中加重组24例,无变化组62例。分析两组患者术后整术眼眼表改变情况,分析滤过泡面积、夹角眼部感觉改变情况的关系。结果两组患者术后的平均眼压均显著低于术前(均P0.05)。随访6个月,薄壁滤过泡计56眼,厚壁滤过泡计30眼。术后患者的角结膜荧光素染色(FSS)评分、虎红染色(RBSS)评分、泪膜仪分级、对称指数(SRI)、不规则指数(SAI)均显著高于术前,潜在视力(PUV)及泪膜破裂时间(BUT)均显著低于术前(均P0.05)。手术前后比较基础泪液分泌试验(Schirmer)情况差异无统计学意义(P0.05)。与无变化组相比,加重组眼部感觉改变的患者滤过泡面积差异无统计学意义(P0.05)。加重组有异物感、畏光感、视力波动以及睁眼困难的患者滤过泡夹角均显著小于无变化组(均P0.05)。根据Spearman法分析可知,上述指标均与滤过泡夹角呈显著负相关(r=-0.615,-0.589,-0.712,-0.698,P=0.000,0.002,0.000,0.000)。与无变化组比较,加重组有干涩感和有痒感的患者滤过泡夹角差异均无统计学意义(均P0.05)。结论青光眼患者接受TRABE之后,恢复效果较好,但加重组的有异物感、畏光感、视力波动以及睁眼困难的患者滤过泡夹角更小,因此应重视其滤过泡角度情况。
[Abstract]:Objective to investigate the relationship between functional bleb morphology and ocular surface changes after trabeculectomy. Methods 86 patients with glaucoma treated with TRABE from June 2012 to June 2013 were divided into two groups according to the changes of ocular surface, including 24 cases with recombination and 62 cases with no change. The changes of ocular surface, the area of filtering bleb and the angle of eye sensation were analyzed. Results the mean IOP in both groups was significantly lower than that before operation (P 0.05). Follow-up for 6 months showed 56 eyes with thin-wall bleb meter and 30 eyes with thick wall bleb meter. The FSS score, red staining score, lacrimal film grading, symmetry index (SRI), irregular index (SAI) were significantly higher in postoperative patients than those before operation, and the latent visual acuity (PUV) and tear film rupture time (but) were significantly lower than those before operation (all P 0.05). Before and after operation, there was no significant difference of Schirmer in basic tear secretion test (P 0.05). Compared with no change group, there was no significant difference in filtration surface product in patients with recombined ocular sensory changes (P 0.05). The angle of bleb in the patients with foreign body sensation, photophobia, visual fluctuation and difficulty in opening eyes was significantly lower than that in the no change group (all P 0.05). According to Spearman method, the above indexes were negatively correlated with the angle of filtration bleb, r-0.615 ~ (-0.589) ~ -0.712 ~ (-1) -0.698 ~ 0.0002 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0.000 ~ 0. Compared with no change group, there was no significant difference in filtration bleb angle between the patients with dry and itchy recombination (all P 0.05). Conclusion the recovery effect of glaucoma patients after receiving TRABE is better, but the patients with foreign body sensation, photophobia, visual fluctuation and difficulty in opening eyes have smaller filtering bleb angle, so we should pay attention to the filtering bleb angle.
【作者单位】：天津港口医院眼科;天津第五中心医院眼科;天津医科大学眼科医院;
【分类号】：R779.6

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