CAJ | 학술논문

目的评价改良小梁切除术联合丝裂霉素在新生血管性青光眼的临床疗效.方法选择我院收治的35例(35眼)新生血管性青光眼患者,予以控制眼压、血糖等措施后采取改良小梁切除术联合丝裂霉素进行治疗,术中应用可调节缝线,并针对患者的眼压及滤过泡来决定可调节缝线的拆除时间.并对35例患者术前及术后6个月的眼压、滤过泡、视力、前房深度及新生血管情况进行随访.结果 35例患者(35眼)术后当日高眼压的症状及体征均消除.术后6个月,35例患者平均眼压为(15.8±7.2)mm Hg,与术前的平均眼压(53.3±9.7)mm Hg比较,眼压显著降低(P＜0.01)；功能性滤过泡约占88.6％；29例患者(29眼)视力较术前均存在程度不一的提高.35例患者(35眼)均保持良好的前房深度；虹膜新生血管全部消退约占31.4％,消退在50％以上约占48.6％,消退在50％以下约占20.0％.结论改良小梁切除术联合丝裂霉素治疗新生血管性青光眼,能有效重建房水循环路径,使患者的症状大大减轻,提高了手术的成功率及安全性.
목적 평개개량소량절제술연합사렬매소재신생혈관성청광안적림상료효.방법 선택아원수치적35례(35안)신생혈관성청광안환자,여이공제안압、혈당등조시후채취개량소량절제술연합사렬매소진행치료,술중응용가조절봉선,병침대환자적안압급려과포래결정가조절봉선적탁제시간.병대35례환자술전급술후6개월적안압、려과포、시력、전방심도급신생혈관정황진행수방.결과 35례환자(35안)술후당일고안압적증상급체정균소제.술후6개월,35례환자평균안압위(15.8±7.2)mm Hg,여술전적평균안압(53.3±9.7)mm Hg비교,안압현저강저(P＜0.01)；공능성려과포약점88.6％；29례환자(29안)시력교술전균존재정도불일적제고.35례환자(35안)균보지량호적전방심도；홍막신생혈관전부소퇴약점31.4％,소퇴재50％이상약점48.6％,소퇴재50％이하약점20.0％.결론 개량소량절제술연합사렬매소치료신생혈관성청광안,능유효중건방수순배로경,사환자적증상대대감경,제고료수술적성공솔급안전성.
Objective To evaluate the clinical efficacy of modified trabeculectomy combined with mitomycin in the treatment of neovascular glaucoma.Methods 35 patients with neovascular glaucoma were given treatment of modified trabeculectomy combined with mitomycin after intraocular pressure and blood sugar were controlled.Removable sutures were applied during operation and removed according to the postoperative intraocular pressure and filtering blebs.Intraocular pressure,filtering blebs,sight,anterior chamber depth and neovascular conditions before and 6 months after operation were observed.Results Symptoms and signs of high intraocular pressure of all of the 35 patients(35 eyes)were cured on the day of operation.6 months after operation,the average intraocular pressure was(15.8 ± 7.2)mmHg,significantly different from preoperative (53.3 ± 9.7)mmHg(P ＜ 0.01).Functional filtering blebs accounted for 88.6％,postoperative sight increased in varying degrees compared with preoperative in 29 patients(29 eyes).All of the 35 patients(35 eyes)kept good anterior chamber depth.31.4％ of iris neovascularization totally eliminated,48.6％ eliminating more than 50％,20.0％ eliminating less than 50％.Conclusions Modified trabeculectomy combined with mitomycin can reconstruct aqueous humor circulation path,greatly reduce the symptoms of patients,and improve the success rate and safety in the treatment of neovascular glaucoma.