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目的探讨小梁切除术联合丝裂霉素C(MMC)及生物羊膜移植可调整缝线治疗难治性青光眼的效果。方法将接受小梁切除术的各类型难治性青光眼38例(44眼)分为3组,A组为治疗组(16眼),巩膜瓣下行羊膜移植术(AMT)联合应用MMC;B组为MMC组(14眼),巩膜瓣下联合应用MMC;C组为对照组(14眼),常规行单纯小梁切除术;3组病例均留置可调整缝线。术后1周、2周、1个月、6个月、12个月观察记录术眼眼压、滤过泡、前房深度情况及并发症。结果术后眼压、滤过泡、前房深度情况及并发症治疗组、MMC组均好于对照组,组间差异有统计学意义(P<0.01)。术后并发症:治疗组少,主要有术后浅前房;MMC组主要有薄壁滤过泡、滤过泡渗漏等。结论小梁切除术联合MMC及生物羊膜移植可调整缝线是治疗难治青光眼的一种有效方法,羊膜植入不仅有抗新生血管和抗瘢痕形成的作用,而且早期还有机械引流的作用。
Objective To investigate the effect of trabeculectomy combined with mitomycin C (MMC) and biological amniotic membrane transplantation for suture refractory glaucoma. Methods Thirty-eight cases (44 eyes) of all types of refractory glaucoma undergoing trabeculectomy were divided into three groups: group A (16 eyes) treated with scleral flap amniotic membrane transplantation (AMT); group B The MMC group (14 eyes), scleral flap combined MMC; C group was the control group (14 eyes), conventional trabecular surgery alone; three groups of patients were placed with adjustable sutures. After 1 week, 2 weeks, 1 month, 6 months and 12 months, the intraocular pressure, filtration bleb, anterior chamber depth and complications were observed and recorded. Results The intraocular pressure, filtration bleb, depth of anterior chamber and complications in the treatment group and MMC group were better than those in the control group. The difference was statistically significant (P <0.01). Postoperative complications: the treatment group less, mainly postoperative shallow anterior chamber; MMC group are mainly thin-wall filtration bleb, filtration bleb leakage. Conclusion Trabeculectomy combined with MMC and biological amniotic membrane transplantation is an effective method for the treatment of refractory glaucoma. Amniotic membrane implantation not only has antiangiogenic and anti-scarring effects, but also has early mechanical drainage.