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目的探讨非穿透性小梁手术(NPTS)联合透明质酸钠生物胶植入的临床疗效。方法对32例(38眼)原发性开角型青光眼实施非穿透性小梁手术联合透明质酸钠生物胶植入术。观察术后视力、眼压、滤过泡、前房反应、前房深浅及并发症。术后随访(14.6±2.3)月。结果术前平均眼压(29.2±8.01)mmHg。术后1周平均眼压(15.01±4.65)mmHg,手术前后眼压差异有统计学意义。术后30眼前房无任何反应,2眼有Ⅰ度浅前房伴少许前房积血,均术后2~3 d自行恢复,6眼轻度房水闪光,术后2~3 d消失。所有患眼术后均形成显著弥散滤过泡。术后1周及6月视力基本稳定。结论非穿透性小梁手术联合透明质酸钠生物胶植入治疗开角型青光眼疗效肯定,并发症少,为开角型青光眼提供了一种更安全的治疗方法。
Objective To investigate the clinical effect of non-penetrating trabecular surgery (NPTS) combined with sodium hyaluronate bio-implants. Methods Thirty-two patients (38 eyes) with primary open-angle glaucoma underwent non-penetrating trabecular surgery combined with sodium hyaluronate bio-implants. Postoperative visual acuity, intraocular pressure, filtration bleb, anterior chamber reaction, anterior chamber depth and complications were observed. The patients were followed up (14.6 ± 2.3) months. Results The average preoperative intraocular pressure (29.2 ± 8.01) mmHg. The mean intraocular pressure (IOP) at 1 week after operation was (15.01 ± 4.65) mmHg, with significant difference in intraocular pressure before and after operation. There was no reaction in anterior chamber in 30 eyes. There were 1 degree shallow anterior chamber with a little hyphema in the anterior chamber. All patients recovered spontaneously 2 ~ 3 days after operation. Six cases had mild aqueous flash and disappeared 2 ~ 3 days after operation. All eyes developed significant postoperative diffuse filtration bleb. Visual acuity was basically stable at 1 week and 6 months after operation. Conclusion Non-penetrating trabecular surgery combined with sodium hyaluronate bio-implants in the treatment of open-angle glaucoma is effective and has fewer complications. It provides a safer treatment for open-angle glaucoma.