摘要
目的 比较丝裂霉素C（Mitomycin C,MMC）与羊膜在青光眼小梁切除术中应用的抗滤过通道瘢痕化的作用.方法 原发性闭角型青光眼38例（68眼）随机分为羊膜组和MMC组各34眼.羊膜组在小梁切除术中联合巩膜瓣下生物羊膜植入;MMC组在小梁切除术中巩膜瓣下一次性应用MMC,浓度为0.3 mg/ml,时间3 min.术后随访10个月.结果 手术成功率：羊膜组的总成功率（包括条件成功率和完全成功率）为94.02％,完全成功率为82.09％;MMC组则分别为81.05％和62.03％,两组之间差异无统计学意义（x2=2.403,P=0.238;x2 =2.101P =0.210）.术后并发症：羊膜组的主要并发症有术后浅前房（6眼）、白内障（2眼）、前房积血（2眼）及薄壁滤过泡（2眼）;MMC组的主要并发症有术后浅前房（8眼）、白内障（7眼）、前房积血（9眼）、薄壁滤过泡（9眼）、持续性低眼压（9眼）、滤过泡渗漏（6眼）及低眼压性黄斑病变（6眼）.结论 羊膜应用于小梁切除术中能长期保留功能性滤泡,且并发症较应用MMC者少.
Objective To compare the anti-scarring effects of amniotic membrane and mitomycin C in glaucoma trabeculectomy.Methods Sixty-eight eyes of 38 cases of angle closure glaucoma were divided into mitomycin C （MMC） group and amniotic membrane group with 34 eyes in each group.In MMC group,the MMC with concentration of 0.3mg/ml was applied only once for 3 min.Patients in amniotic membrane group underwent trabeculectomy combined with amniotic membrane implantation under scleral flap.Patients were followed up for 10 months.Results The total success rate,including conditional success rate and cumulative complete success rate was 81.05% and the complete success rate was 62.03% in MMC group,and they were 94.02% and 82.09% in amniotic membrane group.The differences were statistically significant between two groups （x2=2.403,P=0.238;x2 =2.101,P =0.210）.Postoperative complications in amniotic membrane group included postoperative shallow anterior chamber in 6 eyes,cataract in 2 eyes,hyphema in 2 eyes and thin bleb in 2 eyes.Postoperative complications in MMC group were mainly shallow anterior chanber in 8 eyes,cataract in 7 eyes,hyphema in 9 eyes,thin-wall bleb in 9 eyes,leaking filtering blebs in 6 eyes,persistent hypotony in 9 eyes,and macular disease caused by low intraocular pressure in 6 eyes.Conclusion Amniotic membrane used in trabeculectomy can effectively prevent the scar formation of blebs in operation,and can effectively preserve the functional follicles for a long time with less complication than MMC.
出处
《中华眼外伤职业眼病杂志》
2015年第5期361-364,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
