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目的探讨巩膜池小梁切除术治疗原发性青光眼的临床疗效。方法将60例(60眼)原发性青光眼患者按不同的手术方法分为3组:A组、B组和C组,每组20例(20眼)。A组行巩膜池小梁切除术,B组行丝裂霉素C(MMC)+小梁切除术,C组行常规小梁切除术。术后随访1周,3、6、12、24个月;观察3组患者术后眼压、滤过道大小、视野的变化及有无并发症发生等情况。结果 A、B 2组术后3、6、12、24个月眼压均明显低于C组(均P<0.05)。术后24个月,A、B 2组功能性滤过泡所占比例与C组比较差异均有统计学意义(均P<0.05),A组以Ⅱ型滤过泡为主,B组以I型滤过泡为主,C组Ⅲ型滤过泡为主;B、C 2组滤过道(减压室)值与A组比较差异均有统计学意义(均P<0.05);A、C 2组角膜上皮损伤、前房积血、滤过泡漏、前葡萄膜炎发生率均明显低于B组(P<0.05或P<0.01),B、C 2组浅前房发生率均明显低于A组(均P<0.05)。结论巩膜池小梁切除术能有效增加滤过道的大小,充分发挥减压功效,并能长期、有效控制眼压,且并发症少。
Objective To investigate the clinical efficacy of scleral pool trabeculectomy in the treatment of primary glaucoma. Methods Sixty eyes (60 eyes) of primary glaucoma were divided into three groups according to different surgical methods: group A, group B and group C, with 20 eyes in each group (20 eyes). A group scleral pool trabeculectomy, B group line mitomycin C (MMC) trabeculectomy, C group conventional trabeculectomy. The patients were followed up for 1 week, 3, 6, 12, and 24 months. The postoperative IOP, filtration tract size, visual field changes and the occurrence of complications were observed. Results The intraocular pressure at 3, 6, 12 and 24 months after operation in group A and group B were significantly lower than those in group C (all P <0.05). At 24 months after operation, the percentage of functional bleb in groups A and B 2 was significantly different from that in group C (all P <0.05) Type I bleb, and group C type III bleb; the values of filtration channel (decompression chamber) in group B and C 2 were significantly different from those in group A (all P <0.05); A, The incidence of corneal epithelium injury, hyphema, filtration leakage and anterior uveitis in group C 2 were significantly lower than those in group B (P <0.05 or P <0.01). The incidence of shallow anterior chamber in group B and C were Obviously lower than A group (all P <0.05). Conclusion Trabeculectomy trabeculectomy can effectively increase the size of the filter tract, give full play to the decompression effect, and long-term, effective control of intraocular pressure, and fewer complications.