CAJ | 학술논문

目的:评价个性化"W"形切口延迟性可调整缝线小梁切除术在原发性闭角型青光眼(primarily angle-closure glaucoma,PACG)的临床效果.方法:采用随机对照方法,将48例48眼 PACG患者平均分为两组:试验组和对照组,试验组行"W"形切口延迟性可调整缝线小梁切除术,对照组行常规复合小梁切除手术,随访3～6mo,对比观察两组间视力、眼压、屈光状态、OSDI、泪膜四项和滤过泡、手术成功率及术后并发症等.结果:术前两组散光值、OSDI、泪膜四项差异无统计学意义(t散光=0.764,tOSDI =0.652,tBUT=-1.837,t泪河高度=-1.535,tST =-1.821,tFL =1.916,P 均>0.05),试验组术后1wk,OSDI,BUT,ST,泪河高度及FL均与未发病眼相似,差异无显著性 (tAOSDI =1.052,tABUT=0.974,tA泪河高度=0.998,tAST =-1.225,tAFL =0.784,P均＞0.05);对照组术后1wk,OSDI,BUT,ST,泪河高度及FL与未发病眼相比,差异有显著性 (tBOSDI =14.538,tBBUT=5.241,tB泪河高度=2.694,tBST=-3.189,tBFL=-1.355,P均＜0.05),两组术后2wk,OSDI,BUT,ST,泪河高度及FL均与未发病眼相似,差异无显著性(tAOSDI =0.828,tABUT=0.537,tA泪河高度=0.662,tAST=-0.691,tAFL=0.046;tBOSDI =0.774,tBBUT=1.082,tB泪河高度=0.629,tBST=-0.558,tBFL =-0.719,P均＞0.05).两组术后3mo试验组与对照组在眼压、视力、功能性滤过泡的累积存活率、手术成功率差异无显著性(t眼压=0.292,P均＞0.05;χ2视力=1.928,χ2累积完全成功率=2.669,χ2条件成功率=2.198,P均＞0.05),而形成的术源性散光,滤过泡差异有显著性(t散光=9.964,χ2滤过泡=9.662,P均<0.05).结论:个性化"W"形切口延迟性可调整缝线小梁切除术可以减少PACG患者术后散光并可以较早稳定泪膜、减轻眼表症状,提高患者的视觉质量.
목적:평개개성화"W"형절구연지성가조정봉선소량절제술재원발성폐각형청광안(primarily angle-closure glaucoma,PACG)적림상효과.방법:채용수궤대조방법,장48례48안 PACG환자평균분위량조:시험조화대조조,시험조행"W"형절구연지성가조정봉선소량절제술,대조조행상규복합소량절제수술,수방3～6mo,대비관찰량조간시력、안압、굴광상태、OSDI、루막사항화려과포、수술성공솔급술후병발증등.결과:술전량조산광치、OSDI、루막사항차이무통계학의의(t산광=0.764,tOSDI =0.652,tBUT=-1.837,t루하고도=-1.535,tST =-1.821,tFL =1.916,P 균>0.05),시험조술후1wk,OSDI,BUT,ST,루하고도급FL균여미발병안상사,차이무현저성 (tAOSDI =1.052,tABUT=0.974,tA루하고도=0.998,tAST =-1.225,tAFL =0.784,P균＞0.05);대조조술후1wk,OSDI,BUT,ST,루하고도급FL여미발병안상비,차이유현저성 (tBOSDI =14.538,tBBUT=5.241,tB루하고도=2.694,tBST=-3.189,tBFL=-1.355,P균＜0.05),량조술후2wk,OSDI,BUT,ST,루하고도급FL균여미발병안상사,차이무현저성(tAOSDI =0.828,tABUT=0.537,tA루하고도=0.662,tAST=-0.691,tAFL=0.046;tBOSDI =0.774,tBBUT=1.082,tB루하고도=0.629,tBST=-0.558,tBFL =-0.719,P균＞0.05).량조술후3mo시험조여대조조재안압、시력、공능성려과포적루적존활솔、수술성공솔차이무현저성(t안압=0.292,P균＞0.05;χ2시력=1.928,χ2루적완전성공솔=2.669,χ2조건성공솔=2.198,P균＞0.05),이형성적술원성산광,려과포차이유현저성(t산광=9.964,χ2려과포=9.662,P균<0.05).결론:개성화"W"형절구연지성가조정봉선소량절제술가이감소PACG환자술후산광병가이교조은정루막、감경안표증상,제고환자적시각질량.