目的： 探讨原发性急性闭角型青光眼(PAACG)急性发作患者小梁切除术中联合应用5-氟尿嘧啶(5-FU)及可调节缝线的疗效。

方法： 前瞻性研究。选取2016-10/2019-03我院中年PAACG患者60例60眼，随机分为缝线组、5-FU组和联合组，每组各20例20眼。术后随访6mo，观察患者视力、视野、眼压、辅助治疗及生活质量情况。

结果： 三组患者术后1wk BCVA均较术前提高(P<0.05)。三组术后1wk，1、6mo眼压均较术前降低(均P<0.05)； 术后1、6mo联合组眼压明显低于缝线组和5-FU组(P<0.05)。术后联合组需加用抗青光眼药物的眼数(2眼)及使用抗青光眼药物数量(0.20±0.016种)明显低于缝线组(11眼，0.90±0.068种)和5-FU组(12眼，0.95±0.045种)(均P<0.05)。三组患者术前CLVQOL得分比较无差异(P>0.05)； 术后6mo联合组CLVQOL得分(110.60±2.44分)高于缝线组(101.50±2.61分)和5-FU组(98.55±2.50分)(P<0.05)； 联合组手术前后CLVQOL得分提高值(34.50±4.36分)较缝线组(25.80±3.59分)和5-FU组(23.05±5.44分)明显提高(P<0.05)。

结论：5-FU及可调节缝线在小梁切除术中联合应用治疗中年PAACG急性发作患者安全有效，可以提高生活质量。

METHODS: This was a prospective study. 60 patients(60 eyes)with primary angle-closure glaucoma in middle-aged patients were selected in our hospital from October 2016 to March 2019. Patients were randomly divided into suture group, 5-FU group and combined group, with 20 cases(20 eyes)in each group. Followed up for 6mo postoperatively, the patient's vision, visual field, intraocular pressure, adjuvant therapy and quality of life were observed.

RESULTS:The best corrected visual acuity among the three groups in the first week after operation was higher than that before surgery(P<0.05). The intraocular pressure of the three groups at one week, one month and six months after operation were lower than that before operation(all P<0.05). The intraocular pressure in the combined group were significantly lower than that in the suture group and the 5-FU group at 1mo and 6mo after operation(all P<0.05). The number of eyes with anti-glaucoma drugs(2 eyes)and the number of anti-glaucoma drugs(0.20±0.016)in the combined group after operation were significantly lower than those in the suture group(11 eyes, 0.90±0.068)and the 5-FU group(12 eyes, 0.95±0.045)(all P<0.05). There was no significant differences in preoperative CLVQOL scores among the three groups(P>0.05). The CLVQOL scores of the combined group(110.60±2.44)was higher than that of the suture group(101.50±2.61)and the FU group(98.55±2.50)at 6mo after operation(P<0.05). The increase of CLVQOL scores(34.50±4.36)in the combined group before and after operation was significantly higher than that in the suture group(25.80±3.59)and the FU group(23.05±5.44)(P<0.05).

CONCLUSION: Combined use of 5-FU and adjustable suture in trabeculectomy for the treatment of acute attack of middle-aged primary acute angle-closure glaucoma patients is safe and effective, which can improve the quality of life.