目的：探讨巩膜条反折术和小梁切除联合羊膜植入治疗青光眼患者的疗效。

方法：选取2013-05/2017-06在本院接受治疗的青光眼患者98例116眼，依据随机数字表法将患者分为两组：观察组45例58眼采用巩膜条反折手术和小梁切除术联合羊膜植入术，对照组53例58眼采用小梁切除联合羊膜植入手术； 术后对患者随访3mo，观察患者眼压控制情况； 使用MEN-C90型血液流变分析仪检测全血高切黏度、血浆黏度、血细胞压积及全血低切黏度变化情况，使用多普勒血流成像(CDFI)技术检测眼动脉舒张末期血流速度(EDV)、RI及收缩期峰值血流速度(PSV)等血流动力学指标变化情况。

结果：术后1wk，3mo观察组平均眼压为12.18±0.98、12.23±0.94mmHg，对照组为14.49±1.64、14.62±1.59mmHg，差异有统计学意义(P<0.05)； 观察组患者术后眼压成功控制率为81.0%，高于对照组61.3%，差异有统计学意义(P<0.05)； 术后1wk及3mo两组患者全血高切黏度、血浆黏度、血细胞压积及全血低切黏度均明显下降，与术前比较差异均有统计学意义(P<0.05)，观察组与对照组比较效果更佳，差异有统计学意义(P<0.05)； 术后1wk及3mo两组患者EDV、PSV明显上升，RI明显下降，与术前比较差异均有统计学意义(P<0.05)，观察组与对照组比较效果更佳，差异有统计学意义(P<0.05)。

结论：巩膜条反折术和小梁切除联合羊膜植入术对青光眼患者近期疗效显著，眼压控制效果好，术后并发症少，安全性较高。

METHODS: From May 2013 to June 2017, 98 cases(116 eyes)with glaucoma were treated in our hospital. According to the random number table method, the patients were divided into two groups: the observation group of 45 cases(58 eyes)with scleral slap invagination surgery combined with amniotic membrane transplantation into operation, the control group of 53 cases(58 eyes)with trabeculectomy combined with amniotic membrane implantation. Postoperatively patients were followed up for 3mo to observe IOP control; using MEN-C90 type blood rheology analyzer to detect the whole blood viscosity, plasma viscosity, hematocrit and blood viscosity changes, using the Doppler flow imaging(CDFI)technique for the detection of ophthalmic artery end diastolic velocity(EDV), RI, and the peak systolic velocity(PSV)and other hemodynamic parameters change.

RESULTS: One week and 3mo after the surgery, mean IOP of the observation group was 12.18±0.98mmHg,12.23±0.94mmHg, the control group was 14.49±1.64mmHg, 14.62±1.59mmHg, the difference was statistically significant(P<0.05); IOP successful-control rate of observation group after operation was 81.0%, more than that of the control group(61.3%), the difference was statistically significant(P<0.05). At 1wk and 3mo after operation high blood viscosity, plasma viscosity, hematocrit and blood viscosity of two groups decreased significantly compared with the preoperative(P<0.05); those of the observation group were better than those of the control group(P<0.05). At 1wk and 3mo after operation, EDV and PSV of the two groups increased significantly, RI decreased significantly, compared with the preoperative differences were statistically significant(P<0.05), those of the observation group were better than those of the control group(P<0.05).

CONCLUSION: The combination of scleral slap invagination and amniotic membrane implantation has a significant effect on glaucoma patients, the effect of intraocular pressure control is good, the postoperative complications are low, and the safety of the patients is high.