微穿透性小梁切除术联合羊膜植入治疗开角型青光眼的中远期疗效

目的：研究微穿透性小梁切除术联合羊膜植入术治疗开角型青光眼的中远期疗效及其并发症。方法：对30例（49只眼）开角型青光眼患者行微穿透性小梁切除术联合羊膜植入术，观察术前和术后视力、眼压、视野、滤过泡，并进行统计学分析。结果：随访6~24（15.93±2.35）月。术前及术后24月时眼压分别为（36.84±11.02）mmHg和（18.24±1.34）mmHg(P=0.000)，术前及术后使用的抗青光眼药物分别为（2.76±0.69）种和（0.59±0.89）种（P＜0.05），早中期视野缺损视野指数较术前有改善(P＜0.05)，晚期视野缺损没有改善。术后24月70.8%形成功能性滤过泡，末次随访时手术完全成功率75.5%(37/49)，质量成功率93.9%(46/49)。手术前后视力比较无统计学差异。无严重并发症发生。结论：微穿透性小梁切除术联合羊膜植入是治疗开角型青光眼安全有效的方法，中远期疗效稳定可靠。

Mid-term and long-term clinical effect of micro-perforating trabecular surgery with amniotic membrane implants on open angle glaucoma

ObjectiveTo evaluate the mid-term and long-term clinical effect and complication of micro-perforating trabecular surgery (MPTS) with amniotic membrane implants on open angle glaucoma (OAG). MethodsThirty OAG patients (49 eyes) were treated with MPTS with amniotic membrane implants. Visual acuity, intraocular pressure, visual field, type of blebs， and complications were recorded pre-and post-operatively.ResultsPatients were followed up for 6~24（15.93±2.35） months. The mean IOPs before the operation and 24 months after the operation were (36.84±11.02) mmHg and (18.24±1.34) mmHg, respectively (P=0.000). The mean numbers of anti-glaucoma drugs used before and after the operation were (2.76±0.69) and (0.59±0.89), respectively （P＜0.05）. The global index of the early to moderate glaucomatous visual field loss was significantly improved postoperatively (P＜0.05), and no significant difference was found in aggressive glaucoma pre- and postoperatively. Functional filter bleb was formed in 70.8% patients 24 months after the operation. The complete success rate and quality success rate were 75.5% (37/49) and 93.9% (46/49), respectively. There was no significant change in visual acuity pre- and postoperatively and no severe complication was found. ConclusionMicro-perforating trabecular surgery with amniotic membrane implants is effective and safe for OAG, with reliable effect on lowering IOP in the mid-term and long-term.