目的:探讨难治性青光眼的复合式小梁切除术的临床疗效。方法:回顾性分析2003-08/2008-06我院收治的难治性青光眼共59例59眼,应用常规小梁切除术联合丝裂霉素C(MMC)24例(对照组),应用复合式小梁切除术(常规小梁切除术联合MMC和巩膜可调节缝线)35例(观察组)。分析比较两组术后前房形成、眼压、滤过泡及并发症等情况,结果均经统计学处理。结果:59眼手术顺利,未引发爆发性脉络膜出血等严重并发症,术后追踪12mo。术后第1d浅前房发生率观察组为6%,明显低于对照组29%(P<0.05)。术后随访12mo时,观察组30眼眼压控制在6～21mmHg(86%),对照组15眼眼压控制在6～21mmHg(62%),两组间比较差异有统计学意义(P<0.05),观察组功能性滤过泡占86%,较对照组功能性滤过泡62%为多(P<0.05)。结论:难治性青光眼的复合式小梁切除术可有效降低眼压,且并发症少,是治疗难治性青光眼安全、有效的手术方法之一。

AIM:To investigate the clinical effects of compound trabeculectomy for refractory glaucoma.METHODS: Fifty-nine eyes 59 cases of refractory glaucoma were randomly divided into two groups:35 cases 35 eyes in observe group underwent compound trabeculectomy and 24 cases 24 eyes in control group underwent trabeculectomy.The postoperative intraocular pressure(IOP),filtration,the depth of anterior chamber and postoperative complications were observed between the two groups.RESULTS:In the follow-up of 12 months,59 eyes were successfully healed.The incidence rate of shallow anterior chamber in observe group and control group was 6% and 29% respectively(P<0.05) on the first day of postoperation.12 months later, the eyes with intraocular pressure from 6 to 21mmHg in observe group and control group were 30 eyes(86%) and 15 eyes(62%) respectively(P<0.05).Functional filtering bubles were 86% and 62% respectively(P<0.05).CONCLUSION:Compound trabeculectomy is effective and safe for refractory glaucoma.

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