【摘要】  目的：观察二次可调整缝线在小梁切除术中的疗效及安全性。方法：将173例(343眼)分为对照组和治疗组，观察两组术后眼压、前房及并发症的情况，并作统计学分析。结果：治疗组术后低眼压发生率12.4%，对照组术后低眼压发生率为25.5%，经统计学分析差异有显著性(P <0.01)。治疗组术后浅前房发生率2.2%，对照组术后浅前房发生率为8.5%，经统计学分析差异有显著性(P <0.05)。治疗组术后前房出血，脉络膜脱离，低眼压性黄斑病变发生率9.6%，对照组术后前房出血，脉络膜脱离，低眼压性黄斑病变发生率36.4%，差异有显著性(P <0.005)，出院时两组间功能性滤过泡差异无显著性(P >0.01)。 结论：二次可调整缝线在小梁切除术中可使术后前房迅速形成，减少术后早期并发症，疗效确切并可增加手术安全性。

【关键词】  可调整缝线；小梁切除术；青光眼

    Clinical observation on the quadratic adjustment suture in glaucoma trabeculectomy

    Rui-Fu Wang, Xiao-Wei Gao, Xi-Dong Yan, Xiao-Yun Dong, Xiu-Xiang Ji

    The PLA Eye Center, the 474th Hospital of Chinese PLA, Urumuqi 830011, Sin Kiang Autonomous Region, China

    Abstract AIM: To observe the efficiency and safety of quadratic adjustment suture in glaucoma trabeculectomy.METHODS: One hundred and senventy-three cases(343 eyes) with primary glaucoma were divided into two groups randomly and the quadratic adjustment suture for sclera-flap combining with trabeculectomy was applied to treatment group of 88 cases (178 eyes). The intraocular pressure (IOP), anterior chamber depth, filtering action and complication of post-operation were observed. RESULTS: The low intraocular pressure for the treatment group was 12.4%. The contrasting group was 25.5%(P<0.01).The shallow anterior chamber for the treatment group was 2.2% and the contrasting group was 8.5%(P<0.05). The complication of hyphema, choroidal detachment, hypotony maculopathy for the treatment group was 9.6%. The contrasting group was 36.4%(P<0.005).The functional follicle type Ⅰ+Ⅱ for the treatment group was 98.4%. The contrasting group was 96.4%(P>0.01). CONCLUSION: Applying the adjustment sutune for sclera-flap conbine with trabeculoctomy can prevent post-operation shallow anterior chamber and reduce the incidences of the complication of low intraocular pressure, etc.

    · KEYWORDS: adjustment suture; trabeculectomy; glaucoma

    0引言

    随着可调整缝线在青光眼小梁切除中的应用，明显地减少了术后并发症的发生，有效地控制了手术疗效，我们在可调整缝线基础上做了一些改良，现将我院2003/2005年采用此改良方式治疗青光眼临床疗效报告如下。

    1对象和方法

    1.1对象 2003-03/2005-12首次行青光眼滤过性手术患者。治疗组89例178眼，男43例，女46例；年龄30～76（平均49.18±3.2）岁；急性闭角型青光眼86眼，慢性闭角型青光眼78眼，原发性开角型青光眼14眼。术前眼压24～65（平均38.46±14.32）mmHg，32眼在高眼压状态下手术。对照组84例165眼，男38例，女46例；年龄28～81（平均51.23±2.6）岁；急性闭角型青光眼77眼，慢性闭角型青光眼72眼，原发性开角型青光眼16眼。术前眼压24～58（平均41.46±11.16）mmHg，27眼在高眼压状态下手术。

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