原发性青光眼不同手术方式的效果对比研究

目的比较原发性青光眼3种不同手术方式的效果。方法原发性闭角型及开角型青光眼250例（300眼）随机分成3组。A组，生物羊膜植入手术组92例（108眼）行小梁切除联合生物羊膜植入术；B组，引流器植入手术组80例（104眼）行小梁切除联合青光眼引流器植入术；c组，常规单纯小梁切除术组（对照组）78例（88眼）单纯行常规小梁切除术。术前3个组患者的年龄、青光眼类型及眼压等组间差异均无统计学意义。术后随访1年，观察眼压、前房形成、滤过泡形态及并发症的情况。结果术后1周平均眼压：A组与B组，A组与C组，B组与C组比较差异均无统计学意义（P=0．061，0．074，0．053）；术后1年平均眼压：A组与B组比较差异无统计学意义（P=0．067），但两组眼压均低于C组，差异有统计学意义（P=0．002，0．0001）。术后1周浅前房：3组之间互相比较差异均无统计学意义（P=0．051，0．071，0．063）。术后1年功能性滤过泡：A组与B组比较差异无统计学意义（P=0．054），但两组均高于C组，差异有统计学意义（P=0．003，0．001）。结论小梁切除联合生物羊膜植入术及引流器植入术与单纯小梁切除术相比，均更为安全、更能有效降低眼压，维持功能性滤过泡。

Comparative study of different surgical methods for primary glaucoma

Objective To compare the clinical efficacy of three different surgical methods for primary glaucoma surgery. Methods 300 eyes of 250 cases with primary glaucoma were randomly divided into three groups. Group A was the amnion group （108 eyes of 92 cases） treated with ordinary traheculectomy combined with amniotic membrane transplantation, group B was the drainage group （ 104 eyes of 80 cases） treated with glaucoma drain implants, and group C was the control group （44 eyes of 78cases） treated with ordinary trabeculectomy. There was no statistically significant difference in age, glaucoma type and intraocular pressure among three groups. Patients were followed up for 1 year. The post-operative intraocular pressure （IOP）, anterior chamber, filtration bubble and complications were observed. Results One week after operation, among three groups, the difference of IOP between any two groups had no statistical significance （P = 0.061, 0. 074, 0. 053）. 1 year after operation, the difference of IOP between group A and group B had no statistical significance （P = 0. 067 ）, however, the two groups had lower IOP than the trabeculetomy group （ P = 0. 002, 0. 0001 ） , and the difference was statistically significant. One week after operation, the difference of shallow anterior chamber among the three groups had no statistical significance （P =0.051, 0. 071, 0. 063）. 1 year after operation, the difference of the functional filtration bleb between group A and group B had no statistical significance （ P = 0. 054）, however, the two groups had better functional filtration bleb than the trabeculetomy group （ P = 0. 003, 0. 001 ） , and the difference was statistically significant. Conclusion The trabeculectomy combined with amniotic membrane and glaucoma drain implants are more effective and safer with fewer complications after the operation, and the IOP can be controlled better for a long-term compared with trabeculectomy alone.