目的:观察和探讨氰基丙烯酸正辛酯/正丁酯(N-Octyl-Cyanoacrylate/N-Butyl-Cyanoacrylate)在青光眼小梁切除术中粘合巩膜瓣的方法和临床效果。方法:采用前瞻性临床对照研究,将40例接受青光眼小梁切除术的患者随机分为两组:粘合组20例25眼,用医用胶粘贴巩膜瓣;缝线组20例28眼,用10-0尼龙线缝合巩膜瓣。比较两组术后反应、并发症、眼压、视力、视野等情况。结果:术后随访6～24mo。粘合组25眼与缝线组28眼相比术后平均眼压差异无显著性(P>0.05),粘合组分别有1眼于术后2wk和2眼于术后1mo出现眼压>21mmHg,给予局部药物可控制,缝线组分别有2眼于术后7d出现眼压>21mmHg,1眼给予局部药物可控制,然而另1眼控制无效后于术后6mo给予再次手术治疗;两组均以形成Ⅱ型滤过泡为主,粘合组功能性滤过泡形成率为84%,与缝线组的82%差异无显著性(P>0.05);两组术后并发症较少;所有病例手术前、后视力和视野基本保持不变,无统计学意义。结论:青光眼小梁切除术中使用α-氰基丙烯酸正辛酯(N-OCA)/正丁酯(N-BCA)粘合巩膜瓣安全、简便,可代替传统的缝线缝合并在一定程度上优于缝线,值得在临床上进一步研究及推广。

AIM:To observe and investigate the method and clinical effectiveness of using the N-Octyl-Cyanoacrylate/N-Butyl-Cyanoacryl-ate(N-OCA/N-BCA) on sticking scleral flap in trabeculectomy. ·METHODS:We chose prospective-clinical-contrast study,randomly devided those 40 patients who received glaucoma trabeculectomy into 2 groups:20 patients 25 eyes in the bonding group using cyanoacrylate to stick scleral flap,20 patients 28 eyes in the sutures group using 10-0 nylon line to suture scleral flap. We evaluated the benefits of them with respect to surgical effects,responses,complications,intraocular pressure(IOP),vision,field of vision and so on. ·RESULTS:After following up for 6-24 months,compared the bonding group(25 eyes of 20 cases) with the sutures group(28 eyes of 20 cases),the difference of the postoperative IOP was not statistically significant(P>0.05); After surgery,in bonding group,3 eyes’ (1 eye on two weeks later,2 eyes on one month later) IOP >21mmHg,through local drugs therapy,it fell down to normal level; in sutures group,2 eyes’(7 days later) IOP >21mmHg,through local drugs therapy,1 eye became normal,but another eye failed in this way and took the second surgery six months later; The eyes in two groups mainly tended to form type Ⅱ blebs according to Kronfeld classification,the functional filtration bleb was 84% and 82% in bonding group and sutures group,respectively; Complications in both groups were few; Vision and field of vision almost had no change after surgery,without statistical significance. ·CONCLUSION:The using of N-OCA/N-BCA instead of lines to stick scleral flap in trabeculectomy makes the surgery safer and easier,and can surpass sutures to some extent.It is worth spreading and studying for clinical use.

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