论文部分内容阅读
目的探讨不同球结膜筋膜瓣缝合方式对青光眼小梁切除术后滤泡弥散程度的影响。方法治疗组:女59眼,男41眼,平均57岁。其中急性闭角型青光眼缓解期58眼,慢性闭角型青光眼8眼,原发开角型青光眼34眼。对照组:女58眼,男42眼,平均59岁。其中急性闭角型青光眼缓解期56眼,慢性闭角型青光眼9眼,原发开角型青光眼35眼。采用日产TOPCON裂隙灯观察不同球结膜筋膜瓣缝合方式青光眼小梁切除手术患者术后1个月、6个月、12个月、18个月、24个月时的滤泡弥散程度,探讨缝合方式与滤泡弥散程度的关系。手术方法(术前准备和小梁切除部分省略):做切口时用2%利多卡因紧贴结膜下浸润麻醉,角膜缘上7.5 mm剪开球结膜,向角膜缘方向钝性分离约2 mm,剪开筋膜,勿损伤上直肌鞘膜,缝合时先行将筋膜瓣用8/0可吸收缝线对位连续缝合,后将结膜瓣用8/0可吸收缝线连续缝合,达到筋膜瓣和结膜瓣错层缝合。结果两组术后1~6个月均有良好滤过泡,两组间差异无统计学意义(P>0.05)。术后12个月、18个月、24个月在滤泡弥散程度两组间差异有统计学意义,并且随时间延长显著性增大(P<0.05)。结论治疗组(球结膜筋膜瓣错层缝合)能有效防止滤泡的局限,可明显增加患者的舒适度,有利于眼压的远期控制。
Objective To investigate the effect of different conjunctival fascia flap sutures on the degree of follicular diffusion after glaucoma trabeculectomy. Methods The treatment group: 59 females, 41 males, mean 57 years. Among them, there were 58 eyes of acute angle-closure glaucoma, 8 eyes of chronic angle-closure glaucoma and 34 eyes of primary open-angle glaucoma. Control group: 58 females, 42 males, average 59 years old. Including acute angle-closure glaucoma in 56 cases of remission, chronic angle-closure glaucoma in 9 eyes, primary open-angle glaucoma in 35 eyes. The Nissl TOPCON slit lamp was used to observe the degree of follicular diffusion at 1 month, 6 months, 12 months, 18 months and 24 months after glaucoma trabeculectomy with different conjunctival fascia flap sutures. The relationship between the mode and the degree of follicular diffusion. Surgical procedures (preoperative preparation and trabeculectomy omitted): 2% lidocaine was used to make incision close to subconjunctival infiltration anesthesia, 7.5 mm incisor conjunctival on the limbus, blunt dissection to the limbus about 2 mm , Cut the fascia, do not damage the upper rectus sheath, first fascial fascia flap with 8/0 absorbable suture on the position of continuous suture, the conjunctival flap with 8/0 absorbable suture continuous suture to reach Fascia flap and conjunctival flap stitching. Results Both groups had good filtration bleb 1 to 6 months after operation, with no significant difference between the two groups (P> 0.05). There were significant differences in the extent of follicular diffusion between the two groups at 12 months, 18 months and 24 months after operation (P <0.05). Conclusion The treatment group (conjunctival conjunctival flap split layer suture) can effectively prevent the limitations of follicles, patients can significantly increase the comfort, is conducive to the long-term control of intraocular pressure.