非穿透性小梁手术联合T-FLUX植入术中应用5－氟尿嘧啶治疗开角型青光眼.DOCVIP

临床医学论文-非穿透性小梁手术联合T-FLUX植入术中应用5－氟尿嘧啶治疗开角型青光眼 ??????????? 作者：刘宝海1，徐桂园1，许 洁1，石松艳1，高淑水2，刘春城 【摘要】? 目的? 探讨非穿透性小梁手术（NPTS）联合T-FLUX植入术中应用5－氟尿嘧啶（5-FU）治疗开角型青光眼的临床疗效。方法? 对26例34眼开角型青光眼患者行非穿透性小梁手术联合T-FLUX植入术中应用5-FU。在浅层巩膜瓣下，切除层间巩膜、Schlemm’s管外壁、近管小梁，放置5-FU棉片于巩膜床5min，20ml生理盐水冲洗，植入T-FLUX。术前、术后1、7、15天，1、3、6、12个月检查，以后每3个月进行视力、眼压、裂隙灯、眼底、视野等检查，随访3～12个月，平均（5.26±4.81）个月。结果? 术前平均眼压（32.36±12.37）mmHg(1mmHg=0.133kPa)，最后随访眼压（13.45±3.28）mmHg，均未出现术中、术后浅前房、炎症反应等并发症。结论? 非穿透性小梁手术联合T-FLUX植入术中应用5-FU是治疗开角型青光眼安全、有效的方法。??? ??? 【关键词】? 非穿透性小梁手术；T-FLUX；5－氟尿嘧啶；开角型青光眼??????????????? 【Abstract】? Objective? To investigate the clinical effects of non-penetrating trabecular surgery（NPTS）combined with a T-FLUX implant and 5-FU? in open angle glaucoma. Methods? 34 eyes of 26 patients with open angle glaucoma had been run NPTS combined with a T-FLUX implant and 5-FU. A superficial flap was raised and a deep scelectomy was performed in the scleral bed.Schlemm’s canal was opened to Descemet’s membrane， at which point aqueous percolated through the remaining trabeculo-Descemet’s membrane. 5-FU and T-FLUX was implanted. Vision acuity， intraocular pressure(IOP)， slit lamp and fundus examinations were performed before and after surgery.Results? The mean preoprative IOP was 32.36±12.37mmHg(1mmHg=0.133kPa). The mean postoperative IOP was （13.45±3.28）mmHg at the end of follow-up(3~12months).No postoprative complications occurred in all patients.Conclusion? NPTS combined with a T-FLUX implant and 5-FU is a safe， effective surgery for open angle glaucoma.??? ??? 【Key words】? non-penetrating trabecular surgery；T-FLUX ；5-FU；open angle glaucoma??? ??? 非穿透性小梁手术(non-penetrating trabecular surgery，NPTS)是治疗开角型青光眼的一种新型滤过手术，手术不穿透前房，相对其他滤过性手术有较多优点，术中联合应用生物相容性、热稳定性好的T-FLUX充填及5－氟尿嘧啶（5-FU），术中及术后并发症少，使手术更安全，效果良好，报告如下。??? ??? 1? 资料与方法??? ??? 1.1? 一般资料? 2000年9月~2005年2月收治的中晚期青光眼行非穿透性小梁切除联合T-FLUX植入术的开角型青光眼病人26例34眼，2例外伤性青光眼，1例激素性青光眼；男17例（23眼），女9例（11眼）；年龄36~74岁，平均（58.63±17.82）岁；术前平均眼压（32.36±12.37）mmHg (1mmHg=0.133kPa)，术前矫正视力0.05有17眼，