先天性青光眼小梁切除术中玻璃酸钠的应用
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R779.6

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中国济宁市科技发展计划资助项目(No.济科字\[2008\]51号20)


Application of sodium hyaluranate in trabeculectomy for congenital glaucoma
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Fund for Science & Technology Development of Jining, China(No.20085120)

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    摘要:

    目的:观察玻璃酸钠(sodium hyaluranate,SH)在先天性青光眼小梁切除术中的作用。方法:选择先天性青光眼患者40例69眼,随机分为两组行常规小梁切除术,术中巩膜瓣下放置0.3mg/mL的丝裂霉素C(mitomycin C,MMC)棉片3min,在间断缝合巩膜瓣2针后,观察组向巩膜瓣下及前房内注入SH0.2mL,两侧边作可调节缝线;对照组前房内注入平衡盐溶液,其余操作相同。术后监测并记录视力、眼压、前房深度、滤过泡及并发症发生情况,随访6mo。结果:术后1wk内对照组眼压比观察组低,差异有显著性;末次复诊时两组眼压、视力无统计学差异。术后早期观察组浅前房、前房积血、脉络膜脱离、低眼压性黄斑病变发生率均低于对照组,差异具有显著性(P<0.05)。结论:先天性青光眼小梁切除术中应用SH,可明显减少术后早期滤过过强所致并发症。

    Abstract:

    AIM:To evaluate the effect of sodium hyaluronate(SH)combined with mitomycin C(MMC) in trabeculectomy for congenital glaucoma.METHODS:Forty patients 69 eye were divided into experimental group(33 eyes) and control group(36 eyes) randomly.Trabeculectomy and MMC treatment were performed in all cases,After intermittent suture scleral flap,SH was injected into the anterior chamber and under the sutured scleral flaps in experimental group,however the control group was injected with balanced salt solution(BSS).Visual acuity,intraocular pressure(IOP),the depth of anterior chamber,the filter bleb and complications in the two groups were recorded and analyzed.All patients were followed up for 6 months.RESULTS:Postoperatively,there was no statistically significant difference in visual acuity between two groups(P>0.05).No statistically significant differences in the mean IOP between two groups were found before the operation or 1month,3 and 6 months after the operation(P>0.05).However,a statistically significant difference in the IOP of the two groups was found in the postoperative first week(P<0.05).The incidence of complications in experimental group regarding Flat anterior chamber,hyphema,choroid detachment and hypotension-induced maculopathy were significantly lower than that in control group(P<0.05).CONCLUSION:A small amount of SH injected into anterior chamber and scleral flap can reduce the postoperative complications caused by excessive percolation significantly in trabeculectomy combined with MMC for congenital glaucoma.

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丁凤奎,刘筠,李巧云,等.先天性青光眼小梁切除术中玻璃酸钠的应用.国际眼科杂志, 2011,11(2):247-249.

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