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《慢性病学杂志》[ISSN:1674-8166/CN:11-5900/R]

卷:

期数:

2016年08期

页码:

860-863

栏目:

论著

出版日期:

2016-09-27

文章信息/Info

Title:

Clinical observation of glaucoma drainage valve implantation versus compound trabeculectomy on refractory glaucoma

作者:

胡宏阁; 陈凤月; 程宏松; 杨勇

许昌市中心医院眼科，河南许昌461000

Author(s):

HU Hong-ge;  CHEN Feng-yue;  CHENG Hong-song;  YANG Yong

Department of Ophthalmology, Xuchang Municipal Center Hospital, Xuchang, Henan 461000, China Corresponding author: HU Hong-ge, E-mail: hongge088@163.com

关键词:

Ahmed 青光眼阀; 丝裂霉素C; 小梁切除术; 难治性青光眼

Keywords:

Ahmed glaucoma drainage valve;  Mitomycin C;  Trabeculectomy;  Refractory glaucoma

分类号:

R775

DOI:

-

摘要:

目的对比观察青光眼引流阀植入术和复合式小梁切除术治疗难治性青光眼的临床疗效和并发症。方 法82 例（82 眼） 难治性青光眼随机分为两组，每组41 例（41 眼）。A 组控制眼压后采用青光眼引流阀植入术 治疗，术中联合应用丝裂霉素C；B 组控制眼压后采用复合式小梁切除术治疗。随访观察2 年，对比两组治疗效 果和手术并发症。结果A 组术前平均眼压（41.81±9.09） mm Hg，术后2 年平均眼压（16.15±8.26） mm Hg，差异有统计学意义(t=13.38，P＜0.05)；B 组术前和术后2 年平均眼压分别为（42.03 ± 8.95）、（17.06 ± 8.54） mm Hg，差异有统计学意义(t=12.92，P＜0.05)。2 年后平均眼压组间差异无统计学意义(t=0.49，P＞ 0.05)。A 组术后2 年绝对成功率63.41% ， 相对成功率14.64% ， 总成功率78.05% ； B 组分别为58.54% 、 12.19%、70.73%。总成功率组间差异无统计学意义(χ2=0.58，P＞0.05)。A 组和B 组分别发生并发症13 眼 （31.70%） 和16 眼（39.02%），差异无统计学意义(χ2=0.48，P＞0.05)。结论青光眼引流阀植入术和复合式小 梁切除术两种方法治疗难治性青光眼都是安全、有效的，各有优缺点。

Abstract:

Objective To observe the efficacy and complications of glaucoma valve implantation versus compound trabeculectomy in treatment of refractory glaucoma. Methods Eight- two eyes of 82 cases of refractory glaucoma were divided into 2 groups randomly. Forty-one eyes (41 cases) with refractory glaucoma were followed- up 2 years after glaucoma valve implantation combined using of mitomycin C in groupA. Forty-one cases (41 eyes) diagnosed as refractory glaucoma were followed-up 2 years after trabeculectomy in group B. The efficacy and postoperative complications of two groups were observed and recorded. Results In group A, the average preoperative intraocular pressure (IOP) was (41.81 ± 9.09) mm Hg. Two years postoperative average IOP was (16.15±8.26) mm Hg. There was significant difference between preoperative and postoperative IOP in group A (t=13.38, P＜0.05). In group B, average preoperative IOP was (42.03 ± 8.95) mm Hg. Two years postoperative average IOP was (17.06 ± 8.54) mm Hg. There wassignificant difference between preoperative and postoperative IOP in group B (t=12.92, P＜ 0.05). There was no significant difference between two groups in postoperative IOP (t=0.49, P＞0.05). In group A, 26 (63.41% ) were complete successes, and 6 patients (14.64% ) were qualified successes, and the total success rate was 78.05%. In group B, 24 patients (58.54%) were complete successes, and 5 patients (12.19%) were qualified successes, and the rate of total success was 70.73%. There was no signifi-cant difference between two groups' rate of total success (χ2=0.58, P＞0.05). In group A, 13 eyes (31.70% ) had postoperative complications; in group B, 16 eyes (39.02% ) had complications. There was no significant difference between two groups in postoperative complications (χ2=0.48, P＞0.05). Conclusion Both glaucoma drainage valve implantation and compound trabeculectomy are safe, effective in the treatment of refractory glaucoma, and they have their own advantages and disadvantages.

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备注/Memo

备注/Memo:

作者简介：胡宏阁，硕士，副主任医师，研究方向：青光眼、白内障、视网膜疾病 通信作者：胡宏阁，E-mail: hongge088@163.com

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更新日期/Last Update: 2016-09-27