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原发性闭角型青光眼小梁切除手术睫状突灼烙临床观察
原发性闭角型青光眼小梁切除手术睫状突灼烙临床观察
【摘要】 评价原发性闭角型青光眼(PACG)小梁切除手术中灼烙睫状突的安全性和有效性。方法 选择80例(80眼)原发性闭角型青光眼行小梁切除滤过手术患者,手术中对睫状突行灼烙术设为A组40例(40眼),未行睫状突灼烙术者设为B组40例(40眼),观察两组术后眼压、滤过泡的形成以及并发症的发生情况,术后随访1周、1个月、3个月。结果 (1)眼压:术后3个月,A组平均眼压为(14.2±2.5)mm Hg,明显低于术前(39.4±5.4)mm Hg,差异有统计学意义(P<0.05);术后1周、1个月、3个月两组平均眼压比较,差异无统计学意义(P>0.05)。(2)术后1周期滤过泡的形成:A组Ⅰ和Ⅱ型滤过泡36眼(90%),B组有34眼(85%)。(3)术后并发症:A组前房炎性反应4眼,低眼压性浅前房3眼,无前房出血和恶性青光眼发生;B组前房炎性反应3眼,低眼压性浅前房3眼,前房出血2眼和恶性青光眼发生5眼。结论 在原发性闭角型青光眼小梁切除滤过手术中,对睫状突进行灼烙后,减少恶性青光眼的发生,降眼压效果好,且手术安全。
【关键词】 睫状突灼烙 小梁切除术 原发性闭角型青光眼
[Abstract] Objective To valuate the safety and efficacy of searing ciliary processes on trabeculectomy for PACG.Methods Eighty cases (eighty eyes) with trabeculectomy for PACG were divided into two groups.Forty cases (forty eyes) with searing ciliary processes were group A,and forty cases (forty eyes) without searing ciliary processes were group B.To observe the IOP, blebs and complications after surgery at one week,one month,three months respectively.Results (1)IOP:The average IOP was (14.8±3.1)mm Hg after three months in group A and was obviously lower than preoperation [(39.4± 5.4)mm Hg].The difference was significant ( P<0.05).The difference of average IOP between group A and group B was not significant (P>0.05) at one week,one month,and three months after surgery.(2)The Formation of blebs at one week :There were thirty-six eyes with Type Ⅰ and Type Ⅱ for blebs in group A (90 %),and 34 eyes in group B (85%).(3)The complications:In group A,there were aqueous inflammatory reaction on 4 eyes,shallow anterior chamber with low IOP on 3 eyes,yet no eyes suffered from hyphema or malignant glaucoma.In group B,there were aqueous fire on 3 eyes,shallow anterior chamber with low IOP on 3 eyes,there were 2 eyes suffering from hyphema and 5 eyes suffering from malignant glaucoma.Conclusion To sear ciliary processes on trabeculectomy for PACG can reduce incidence of malignant and hyphema and is safe.
[Key words] searing ciliary processes;trabeculectomy;PACG
闭角型青光眼
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