论文部分内容阅读
目的 :探讨羊膜与丝裂霉素C (MMC)应用于小梁切除术的临床疗效。方法 :采用随机对照的方法 ,施行同一标准的小梁切除术 ,将 2 6例 (4 2眼 )闭角型青光眼患者分为羊膜组和MMC组各 2 1眼。前者施行小梁切除术联合巩膜瓣下羊膜植入术 ,后者在术中一次性应用MMC ,浓度为 0 2 5mg/ml ,共 5分钟。随访 6个月。结果 :手术成功率 :羊膜组的累积完全成功率和条件成功率分别为 86 2 3 %和 96 68% ,MMC组的累积完全成功率和条件成功率分别为 5 8 79%和 79 5 6% (P <0 0 1)。功能性滤过泡的累积存活率羊膜组为 86 2 6% ,MMC组为 5 1 3 3 % ,两组之间有显著性差异 (P <0 0 1)。术后视力 :MMC组术后视力下降者 10眼 (4 7 6% ) ,羊膜组则只有 2眼 (11 8% )。两组间差异有显著性 (P <0 0 5 )。并后并发症 :羊膜对眼部的副作用小 ,引起的并发症主要有术后浅前房 ;MMC引起的眼部并发症主要有薄壁滤过泡、术后浅前房、滤过泡渗漏、前房出血、持续性低眼压、低眼压性黄斑病变等。结论 :羊膜应用于小梁切除术可有效地防止滤过泡的瘢痕组织形成 ,并能有效长期保留功能性滤泡 ,且并发症较MMC少
Objective: To investigate the clinical efficacy of amniotic membrane and mitomycin C (MMC) in trabeculectomy. Methods: A total of 26 patients (42 eyes) with angle-closure glaucoma were divided into amnion group and MMC group with 21 eyes using a randomized controlled trial. The former trabeculectomy combined scleral flap amniotic membrane implantation, the latter one-time intraoperative application of MMC, a concentration of 025mg / ml, a total of 5 minutes. Follow up for 6 months. Results: The success rate of successful operation was 86 2 3% and 96 68%, respectively. The cumulative success rate and conditional success rate of MMC group were 58.99% and 79.56% respectively, (P <0 0 1). The cumulative viability of functional bleb was 86.2% in the amniotic membrane group and 51.33% in the MMC group, with significant differences between the two groups (P <0.01). Postoperative visual acuity: 10 eyes (476%) in the MMC group and 2 eyes (11.8%) in the amniotic membrane group. The difference between the two groups was significant (P <0 05). And complications: the side effects of amniotic membrane on the eye is small, the main complications caused by postoperative shallow anterior chamber; MMC-induced eye complications are mainly thin-wall filtration bleb, postoperative shallow anterior chamber, filtration bleed through Leakage, hyphema, persistent low intraocular pressure, low ocular macular degeneration and so on. Conclusion: The application of amniotic membrane in trabeculectomy can effectively prevent the formation of scar tissue in filtration bleb, and can effectively retain functional follicles for a long time, with less complications than MMC