摘要
目的:探讨房水引流管植入联合羊膜移植对角膜移植术后难治性青光眼的治疗作用。方法:应用α-糜蛋白酶行兔眼后房注射制备青光眼动物模型,把它们随机分为对照组、单纯引流管植入组、引流管植入加羊膜移植组、引流管加羊膜支架植入联合羊膜移植组,观察眼内压、管周组织学改变、引流管周组织渗透性,并且比较各治疗组对难治性青光眼的疗效。临床上,41例(42眼)穿透性角膜移植术后青光眼进行了房水引流管植入联合羊膜移植12眼和单盘Molteno房水引流植入物术30眼,并且比较两种方法的疗效。结果:兔眼后房注射α-糜蛋白酶后,所有的手术眼眼内压升高,术后第3天达到高峰,3天后眼内压渐降。对照组手术3月后眼内压是33.34±5.54mmHg(1mmHg=0.133kPa)。单纯房水引流管组手术3月后眼内压是27.88±8.86mmHg,与对照组相比无显著性降低眼内压的作用(P=0.274)。引流管+羊膜移植组手术3月后眼内压是22.33±3.73mmHg,与对照组相比有显著性降低眼内压的作用(P=0.02),与单独引流管植入组相比无显著性降低眼内压的作用(P=0.113)。引流管+羊膜支架+羊膜移植组手术3月后眼内压是15.74±2.94mmHg,与对照组和引流管组相比均有显著性降低眼内压的作用(P=0.001和P=0.036),与引流管+羊膜移植组相比无显著性降低眼内压的作用(P=0.09)。
Purpose: To investigate the therapeutic effect of aqueous humor shunt implants with amniotic membrane transplantation on intractable glaucoma.
Methods: Glaucoma was induced in rabbits by the injection of ot-chymotrypsin into the posterior chamber of the eyes. The rabbits were divided into four groups. Group A: control group, Group B: single shunt tube group, Group C: shunt tube with amniotic membrane transplantation group, Group D: shunt tube with amniotic supporter and amniotic membrane transplantation group. The intraocular pressure (IOP), histology and filterable ability of the tissue around the tubes were studied. The therapeutic effect of the three methods for the glaucoma was compared. From 1998 to 1999,42 eyes of 41 patients with uncontrolled glacoma after penetrating keratoplasty were randomly assigned into two groups. One group (12 eyes) underwent implantation of shunt tube combining transplantation of amniotic membrane. The other group underwent implantation of a single plate Molteno implant. Clinical records were reviewed to ascertain postoperative IOP, visual acuities, number of medications.
Results: The IOP elevated after the operation and reached at the peak on the third day for all groups and then dropped slowly. The IOP was 33. 34 ±5. 54 mmHg (1 mmHg -0. 133kPa) for Group A and 27. 88±8. 86 mmHg for Group B three months after the operation. There was no statistical difference between the two groups ( P = 0. 274) . The IOP was 22. 33±3. 73 mmHg for Group C and there was statistical significant difference between Group C and Group A (P = 0. 02) and no difference between Group C and Group B ( P = 0. 113). The IOP was 15. 74±2. 94 mmHg for Group D and there was statistical significant difference between Group D and Group A ( P = 0. 001) and Group B ( P -0. 036). There was no difference between Group D and Group C ( P = 0. 09). The study of horseradish peroxidase penetrability indicated that there was peroxidase in the tissues around the tube with amniotic membrane transplantati
出处
《眼科学报》
2000年第2期65-72,共8页
Eye Science
关键词
青光眼
角膜移植术
引流管植入
羊膜移植
shunt tube, amniotic membrane transplantation, Molteno implant, penetrating keratoplasty, glaucoma
