论文部分内容阅读
为探讨青光眼滤过性手术后早期滤过泡失败的再治疗及应用干扰素α－２ｂ（ＩＦＮα－２ｂ）的疗效，我们采取前瞻性研究方法，应用ＩＦＮα－２ｂ对２１例２６只眼早期滤过泡失败的病例进行滤过泡针刺分离和球结膜下注射，其中早期滤过泡疤痕化或疤痕倾向１９只眼，包裹性囊状泡７只眼。所有患眼接受小梁切除术时，术中曾应用过抗代谢药ＭＭＣ（０．２ｍｇ／ｍｌ－０．３ｍｇ／ｍｌ）。术后发生滤过泡失败的时间平均２２．０±８．７天。结果：随访时间最长１３个月，最短６个月，平均９．４±１．９个月。治疗前平均眼压２３．２１±６．５ｍｍＨｇ，治疗后平均眼压１６．１０±５．１８ｍｍＨｇ，治疗前后眼压差异有显著性（Ｐ＜０．００１）。治疗后有１８只眼形成功能性滤过泡，治疗的完全成功率为６９．２％，条件成功率９２．３％。结论：应用ＩＦＮα－２ｂ对早期滤过泡失败病例进行针刺分离和注射治疗可获良好的疗效，可挽救一部分濒临失败的滤过泡，而且操作简单、安全、并发症少，具有比５－Ｆｕ更理想的优点。本文强调早期发现和早期治疗是治疗成功的关键。并提出利用ＵＢＭ技术监测滤过泡失败再治疗的效果是值得探讨的方法
To investigate the re-treatment of early filtration bleb failure after glaucoma filtration surgery and the therapeutic effect of interferon α-2b (IFNα-2b), a prospective study was conducted to investigate the effects of IFNα-2b on early filtration In the case of failure of over-blistering, bleb filtration and subconjunctival injection were performed. Among them, 19 eyes had early scarring or scars of filtering bleb, and 7 eyes wrapped cystic bubble. All patients with trabeculectomy surgery, surgery has been used anti-metabolite MMC (0.2mg / ml-0.3mg / ml). Postoperative bleeding bleb bleaching averaging 22.0 ± 8.7 days. Results: The longest follow-up was 13 months, the shortest 6 months, with an average of 9.4 ± 1.9 months. The average intraocular pressure before treatment was 23.21 ± 6.5mmHg, and the average intraocular pressure after treatment was 16.10 ± 5.18mmHg. There was significant difference in intraocular pressure before and after treatment (P <0.001). After treatment, 18 eyes formed functional filter bleb, the complete success rate of treatment was 69.2%, the conditional success rate was 92.3%. CONCLUSION: IFNα-2b is effective in treating early failure of bleb filtration by acupuncture. It can save part of the filtration bleb on the verge of failure, and is simple, safe and has fewer complications than 5- Fu more desirable advantages. This article emphasizes that early detection and early treatment are the keys to successful treatment. And put forward the use of UBM technology to monitor the effect of filtration bleb failure re-treatment is worth exploring