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目的探讨抗青光眼滤过术联合羊膜移植治疗青光眼的效果。方法收集2007年9月至2009年9月湖北民族学院附属医院眼科入院确诊的青光眼患者40例(48只眼),采用随机对照临床实验方法,施行统一的小梁切除术,26只眼为移植组,22只眼为对照组。移植组术中在巩膜瓣下植入羊膜移植片,对照组术中巩膜瓣下未植入羊膜移植片。术后随访观察6个月至3年。结果移植组和对照组的手术完全成功率分别为69%和54%,总有效率分别为88%和77%,组间差异有统计学意义(P<0.01);移植组中的非功能性滤过泡(Ⅲ、IV型)发生率为7.69%,对照组为18.18%,差异有统计学意义(P<0.01)。移植组术后视力好于对照组(P<0.01)。2组并发症比较无统计学意义(P>0.05)。结论羊膜移植可减少滤过道疤痕的形成,显著提高青光眼滤过术的成功率,是治疗青光眼安全有效的方法之一。
Objective To investigate the effect of anti-glaucoma filtration and amniotic membrane transplantation in the treatment of glaucoma. Methods Forty patients (48 eyes) with glaucoma admitted to Department of Ophthalmology, Hubei Provincial College of Nationalities from September 2007 to September 2009 were enrolled in this study. A total of 40 eyes (48 eyes) were enrolled in this study. Group, 22 eyes as control group. In the transplantation group, the amniotic membrane was implanted under the scleral flap, while the amniotic membrane was not implanted in the control group under the scleral flap. Postoperative follow-up observation of 6 months to 3 years. Results The complete success rate was 69% in the transplantation group and 54% in the control group, with a total effective rate of 88% and 77%, respectively. The difference between the two groups was statistically significant (P <0.01) The incidence of bleb (type Ⅲ, type IV) was 7.69% in the control group and 18.18% in the control group, the difference was statistically significant (P <0.01). Visual acuity in the transplantation group was better than that in the control group (P <0.01). There was no significant difference in complications between the two groups (P> 0.05). Conclusion Amniotic membrane transplantation can reduce the formation of scar in trachea and significantly improve the success rate of glaucoma filtration. It is one of the safe and effective methods to treat glaucoma.