【摘要】  　　目的：探讨小梁切除联合巩膜瓣下甘油保存羊膜植入治疗难治性青光眼的临床疗效。方法：对完成随访观察的12例（17眼）难治性青光眼患者施行小梁切除联合巩膜瓣下甘油保存羊膜植入。 结果：术后随访6～24mo，88%的患者眼压得到良好控制，功能性滤过泡形成率为88%，无明显严重并发症发生；2例新生血管性青光眼分别于术后2,3mo眼压复升，手术失败。结论：小梁切除联合巩膜瓣下甘油保存羊膜植入手术，功能性滤过泡形成良好，眼压控制满意，可作为治疗难治性青光眼一种新的、有效的尝试术式。

【关键词】  难治性青光眼　甘油保存羊膜　移植　小梁切除术

　　Complicated glaucoma treated by trabeculectomy and transplanted amnion conserved in glycerine under scleral flap

    Su-Qiang Du, Guang-Hui Xia, Wei-Lin Xu, Qiu-Guo Li

    Department of Ophthalmology, People's Hospital of Fugou Country, Fugou 461300, Henan Province, China

     Abstract AIM: To study the clinical effect of trabeculectomy and transplanted amnion conserved in glycerine under scleral flap on complicated glaucoma. METHODS: Twelve patients (17 eyes) with complicated glaucoma were administrated trabeculectomy and transplanted amnion conserved in glycerine under scleral flap. RECULTS: After 6-24 months follow-up, the intra-ocular tension of 12 eyes (88%) were controlled well, and the rate of functional bulb form was 88％ with no manifest severe complications. The operation on two neovascular glaucoma patients was failed because the intraocular tension rised again at 2 and 3 months after operation.ONCLUSION: The intra-ocular tension after trabeculectomy and transplanted amnion conserved in glycerine under scleral flap was controlled well, and functional bulb formed well. So it is an original and effective operation to treat complicated glaucoma.

    · KEYWORDS: complicated glaucoma; amnion conserved in glycerine; transplantion; trabeculectomy

　　0引言

    小梁切除术是目前治疗青光眼最常见的手术方法之一，适用于多种类型青光眼的手术治疗。但常由于成纤维细胞增殖和胶原的产生使滤过泡瘢痕化而导致手术失败。2a内的手术失败率可达15%～25%[1]。某些难治性青光眼如青少年型青光眼，继发性青光眼，持续性高眼压、迁延不愈的急性闭角性青光眼，新生血管性青光眼及青光眼滤过手术失败的青光眼，其手术效果较差，手术后常发生局部纤维化及炎性反应，更易导致滤过道瘢痕化，即使使用抗代谢药物，亦不能有效防止手术失败。我们于2003-09/2006-06，将甘油保存羊膜应用于难治性青光眼小梁切除术中，术后观察患者滤过泡形成良好，眼压控制满意。

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