摘要
目的比较Ahmed青光眼引流阀(AGV)植入术与小梁切除术治疗外伤性青光眼的效果。方法前瞻性随机对照研究。纳入2018年1月至2020年10月洛阳市第三人民医院收治的外伤性青光眼80例(80只眼),按随机数字表法分为两组,每组各40例。观察组进行AGV植入术,对照组进行小梁切除术,术后随访12个月,比较两组手术成功率、眼压、角膜内皮细胞密度(ECD)及并发症发生情况。结果术后12个月,观察组手术成功率为82.50%(33/40),明显高于对照组的62.50%(25/40)(χ^(2)=4.01,P=0.045)。两组眼压比较均低于术前,且观察组术后各时点眼压均明显低于对照组。术后12个月眼压观察组为(16.46±2.64)mmHg(1 mmHg=0.133 kPa)低于对照组(21.51±5.24)mmHg(t=5.44,P<0.05)。两组术后ECD均低于术前,随时间推移ECD逐渐降低,且观察组术后各时点ECD均低于对照组,术后12个月,观察组为(1979.67±301.37)个/mm^(2)低于对照组(2150.74±351.92)个/mm^(2)(t=2.34,P=0.020)。观察组的并发症高眼压发生率为27.50%(11/40),明显低于对照组的60.00%(24/40)(χ^(2)=8.58,P=0.003)。结论外伤性青光眼接受AGV植入术与小梁切除术治疗各具优势,AGV植入术有利于术后眼压、长远效果好,而小梁切除术有利于保护角膜内皮。
Objective To compare the efficacy between the implantation of Ahmed glaucoma valve(AGV)and trabeculectomy in the treatment of traumatic glaucoma.Methods This was a prospective randomized control study.Eighty eyes of 80 cases with traumatic glaucoma treated in the Third People’s Hospital from Jan.2018 to Oct.2020 were included and all cases were divided into two groups based on random number table methods,with 40 cases in each group.The observation group underwent AGV implantation,the control group underwent trabeculectomy,and the postoperative follow-up was 12 months.The success rate of the procedure,intraocular pressure,corneal endothelial cell density(ECD)and the occurrence of complications in the two groups were observed and compared.Results The success rate in the observation group at 12 months after operation was 82.50%(33/40),which was significantly higher than the 62.50%(25/40)in the control group(χ^(2)=4.01,P=0.045).The intraocular pressure in the two groups was lower than that before operation and gradually increased with time,and the intraocular pressure in the observation group was significantly lower than that in the control group at all time points after operation.At 12 months after operation,the intraocular pressure in the observation group was(16.46±2.64)mmHg,which was lower than the(21.51±5.24)mmHg in the control group(1 mmHg=0.133 kPa,t=5.44,P<0.05).The postoperative corneal endothelial cell density(ECD)of the two groups was lower than that before operation,and the ECD of the observation group was lower than that of the control group at all time points.At 12 months after operation,the ECD of the observation group was(1979.67±301.37)cells/mm^(2),which was lower than that of the control group(2150.74±351.92)cells/mm^(2)(t=2.34,P=0.020).The rate of high IOP in the observation group were 27.50%(11/40),which was significantly lower than the 60.00%(24/40)in the control group(χ^(2)=8.58,P=0.003).Conclusion Modified AGV implantation and trabeculectomy for traumatic glaucoma have their own advantages and disadvantages.Modified AGV implantation is beneficial to postoperative intraocular pressure with long-term effects,while trabeculectomy is beneficial to protecting the corneal endothelium.
作者
王晓英
朱兰香
梁静
Wang Xiaoying;Zhu Lanxiang;Liang Jing(Department of Ophthalmology,the Third People’s Hospital,Luoyang 471000,China)
出处
《中华眼外伤职业眼病杂志》
2022年第8期570-575,共6页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
