摘要
为探讨治疗非新生血管性顽固性青光眼的有效方法，对３７例（４６眼）非新生血管性顽固性青光眼，随机分为ＨＡＤ房水引流物置入术组（ＨＡＤ组，２４眼）与小梁切除术联合应用丝裂霉素Ｃ治疗组（ＭＭＣ组，２２只眼），平均随访１５８月（３～３４月）。术后一年眼压峰值（Ｘ±ＳＤ）：ＨＡＤ组为１７０±６４ｍｍＨｇ，ＭＭＣ组为１８７±７５ｍｍＨｇ（Ｐ＜００５）；眼压下降率（Ｘ±ＳＤ）：ＨＡＤ组为６３５％±１７９％，ＭＭＣ组为４９６％±１７４％（Ｐ＜００５）。手术成功率：术后一年ＨＡＤ组为９００％，ＭＭＣ组为８２４％（Ｐ＞００５）；术后一年半时，ＨＡＤ组为８８９％，ＭＭＣ组为７００％（Ｐ＞００５）；术后两年时，ＨＡＤ组为８３３％，ＭＭＣ组为５７１％（Ｐ＞００５）。术后并发症，ＭＭＣ组前房积血（３６４％）多见（Ｐ＜００１），此外还可见到低眼压性黄斑病变（４５％）等并发症；ＨＡＤ组亦有引流管前房端纤维膜闭（１６７％），引流管与其周围虹膜粘连（８３％）等并发症。结果：本组病例行ＨＡＤ房水引流物置入术的手术成功率与国外同类产品相似。在常规滤过性手术联合应用抗瘢痕形成药物治疗顽固性青光眼失败?
To research the effective management in non neovascular glaucoma.37 patients(46 eyes)with non neovascular refractory glaucoma subgrouped randomly into Hunan Aqueous Drainage implantation operation group(HAD group,24 eyes)and Trabeculectomy combined with Mitomycin C group as control group(MMC group,22eyes). Results:The average followed up was 15 8(range,3～34)months.The IOP peak(±S)at one year after surgery was 17 0±6 4mmHg in HAD group and 18 7±7 5mmHg in MMC group(P<0 05).The percentage of IOP decreased(±S)was 63 5%±17 9% in HAD group and 49 6%±17 4% in MMC group(P<0 05).The success rates(IOP≤21mmHg)at one year,one and half years and two years intervals were 90 0%,88 9%,83 3% in HAD group and 82 4%,70 0%,57 1% in MMC group,respectively.The commonly postoperative complications were hyphema(36 4%)(p<0 01)and other ones,such as hypotous maculopathy(4 5%)were found in MMC group.There were blockage of the proximal end of the tube in the anterior chamber of the eye by fibrous membrane(16 7%)and anterior synechia around the proximal orifice of the tube(8 3%)and other complications in HAD group.Conclusion:The success rate of HAD implantation surgery was consistent with the foreign same type products.After refractory glaucoma treated by routinely filtering surgery combined with antifibroblasts proliferation drugs was failed,this implantation surgery can be chosen.Therefore,a safe and effective management in refractory glaucoma was recommended,but a follow up study should be conducted to confirm the long term results.
出处
《中国实用眼科杂志》
CSCD
1998年第4期226-229,共4页
Chinese Journal of Practical Ophthalmology
