小梁切除术联合MMC及生物羊膜移植可调整缝线治疗难治性青光眼的临床观察

目的探讨小梁切除术联合丝裂霉素C（MMC）及生物羊膜移植可调整缝线治疗难治性青光眼的效果。方法将接受小梁切除术的各类型难治性青光眼38例（44眼）分为3组，A组为治疗组（16眼），巩膜瓣下行羊膜移植术（AMT）联合应用MMC；B组为MMC组（14眼），巩膜瓣下联合应用MMC；C组为对照组（14眼），常规行单纯小梁切除术；3组病例均留置可调整缝线。术后1周、2周、1个月、6个月、12个月观察记录术眼眼压、滤过泡、前房深度情况及并发症。结果术后眼压、滤过泡、前房深度情况及并发症治疗组、MMC组均好于对照组．组间差异有统计学意义（P〈0．01）。术后并发症：治疗组少，主要有术后浅前房；MMC组主要有薄壁滤过泡、滤过泡渗漏等。结论小梁切除术联合MMC及生物羊膜移植可调整缝线是治疗难治青光眼的一种有效方法，羊膜植入不仅有抗新生血管和抗瘢痕形成的作用，而且早期还有机械引流的作用。

Trabeculectomy with mitomycin-C and amniotic membrane transplantation and adjustable suture for refractory glaucoma

Objective To investigate the effects of trabeculectomy with mitomycin-C and amniotic membrane transplantation and adjustable suture for refractory glaucoma. Methods 38 cases（44 eyes） with refractory glaucoma trabeculectomy were divided into three groups ： the amniotic membrane transplantation and mitomycin C （ （ AMT and MMC ） group （ 16 eyes）, the MMC group （ 14 eyes） and control group （ 14 eyes）. Adjustable suture was applied to all the pa- tients. The operative intraocular pressure （lOP）, filtering bubbles, anterior chamber depth and postoperative complica- tions were determined and recorded 1 week, 2 weeks, 6 months and 12 months after operation. Results The postoperative lOP, filtering bubbles, anterior chamber depth and postoperative complications in the AMT and MMC group were better than those of the control group（ P 〈 0.01 ）. The postoperative complications in the AMT and MMC group were rare, mainly involving the shallow anterior chamber; but in the MMC group they were mainly thin wall filtering bubble, or bubble leaking etc. Conclusion Trabeculectomy with Mitomycin-C and amniotic membrane transplantation and ad- justable suture is an effective method to treat glaucoma. Amniotic membrane transplantation has the effects of anti-neo- vacularization , anti-scarring agent ,and mechanical drainage in early time.