开角型青光眼小梁切除术中应用胶原蛋白基质与MMC的疗效比较
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Collagen matrix compared with mitomycin C for treatment of primary open-angle glaucoma with trabeculectomy performed
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    摘要:

    目的:观察开角型青光眼行小梁切除术中应用胶原蛋白基质与MMC的临床效果,评价两组术后有效性及安全性。

    方法:选取2015-01/2016-12于我院诊断为开角型青光眼的患者24例32眼,随机分为两组,行小梁切除术中应用胶原蛋白基质12例14眼为研究组; 行小梁切除术中应用MMC 12例18眼为对照组。观察两组患者术后1d,1wk,1、3、6mo眼压、手术成功率、术后应用降眼压药物情况及手术并发症情况。

    结果:术后1d两组患者眼压均数差异有统计学差异(P<0.05)。术后1wk,1mo两组患者眼压均数差异无统计学差异(P>0.05),术后3、6mo两组患者眼压均数差异性有计学意义(P<0.05)。术后6mo两组患者手术成功率差异无统计学意义(P>0.05)。两组患者术前眼压均值在术后1d有明显下降趋势,术后1wk~ 6mo眼压均数水平趋向平稳,术后3、6mo研究组平均眼压水平线较对照组低。术后6mo研究组有28%患者需要用降眼压眼液控制眼压,对照组有33%患者需要用降眼压眼液控制眼压,两组间比较无统计学意义(P>0.05)。研究组与对照组术后1d并发症发生率比较无统计学意义(P>0.05)。

    结论:开角型青光眼小梁切除术应用胶原蛋白基质的手术成功率与应用MMC的治疗效果相似,其降低眼压幅度较应用MMC明显,其避免术后发生低眼压、浅前房、结膜伤口渗漏并发症较应用MMC无明显优势。

    Abstract:

    AIM:To evaluate the effectiveness and safety between trabeculectomy with collagen matrix versus trabeculectomy with mitomycin C(MMC)for patients with primary open-angle glaucoma(POAG).

    METHODS: In this prospective randomized comparative study from January 2015 to December 2016. Thirty-two eyes presented with POAG were included in this study, 14 eyes treated by trabeculectomy with subconjunctival implant of collagen matrix(study group)and the other 18 eyes treated by trabeculectomy with mitomycin C. Postoperative IOP, the success rate of operation, number of postoperative glaucoma medications and postoperative complications were recorded. Each patient was followed up at least 6mo.

    RESULTS: The mean postoperative IOP was statistically different between the study group and the control group after 1d(P<0.05), while not statistically different at 1 and 1mo follow-up(P>0.05), and the mean postoperative IOP was statistically different between the two groups(P<0.05)at 3 and 6mo after surgery. There was no significant difference in the success rate of operation between the two groups at 6mo after operation(P>0.05). The IOP decreased at 1d after openations compared with before, kept stable at 1wk to 6mo. IOP of study group was lowen than control. IOP was controlled by glaucoma medications in the study group by 28% compared to control group by 33% at 6mo after operation, but there was no significant difference. There was no significant difference between the study group and the control group in complications(P<0.05).

    CONCLUSION: Trabeculectomy with collagen matrix implant is comparable to the use of MMC with a similar success rate in open-angle glaucoma and the range in reducing intraocular pressure was significantly higher than that of MMC and it can significantly avoid the occurrence of low IOP postoperatively, transient anterior chamber, conjunctival wound leakage complications has no advantages compared with the use of MMC.

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于磊,秦虹.开角型青光眼小梁切除术中应用胶原蛋白基质与MMC的疗效比较.国际眼科杂志, 2017,17(9):1712-1715.

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  • 收稿日期:2017-04-16
  • 最后修改日期:2017-08-04
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  • 在线发布日期: 2017-08-22
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