羊膜移植修复青光眼滤过泡渗漏的长期疗效

Long-term outcomes of amniotic membrane transplantation for repair of leaking glaucoma filtering blebs.

作者信息

Rauscher Frederick M, Barton Keith, Budenz Donald L, Feuer William J, Tseng Scheffer C G

机构信息

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida 33136, USA.

出版信息

Am J Ophthalmol. 2007 Jun;143(6):1052-4. doi: 10.1016/j.ajo.2007.01.016.

DOI:10.1016/j.ajo.2007.01.016

PMID:17524779

Abstract

PURPOSE

To report long-term results of human preserved amniotic membrane transplant (AMT) vs conjunctival advancement for repair of late-onset glaucoma filtering bleb leakage.

DESIGN

Randomized, controlled trial (n = 30).

METHODS

Rates of bleb failure (reoperation for glaucoma or recurrent bleb leak) were compared.

RESULTS

Median follow-up was 80 months. Final intraocular pressure (IOP) was 10.9 +/- 0.9 mm Hg with AMT and 12.7 +/- 1.3 mm Hg with conjunctival advancement (P = .28). The number of glaucoma medications and final visual acuities were similar between groups. Bleb vascularity was significantly less with AMT (P = .02). Seven failures occurred with AMT, four requiring reoperation for bleb leakage and three requiring reoperation for glaucoma. Four failures occurred with conjunctival advancement, one requiring reoperation for leakage and three requiring reoperation for glaucoma. Kaplan-Meier survival curves were statistically similar between groups, with a trend favoring conjunctival advancement (P = .44).

CONCLUSIONS

Although prone to early releakage, AMT may be a suitable alternative to conjunctival advancement in the long-term.

摘要

目的

报告人类保存羊膜移植（AMT）与结膜推进术治疗迟发性青光眼滤过泡渗漏的长期结果。

设计

随机对照试验（n = 30）。

方法

比较滤过泡失败率（因青光眼再次手术或滤过泡反复渗漏）。

结果

中位随访时间为80个月。AMT组最终眼压（IOP）为10.9±0.9 mmHg，结膜推进术组为12.7±1.3 mmHg（P = 0.28）。两组青光眼药物使用数量和最终视力相似。AMT组滤过泡血管化程度明显较低（P = 0.02）。AMT组发生7例失败，4例因滤过泡渗漏需要再次手术，3例因青光眼需要再次手术。结膜推进术组发生4例失败，1例因渗漏需要再次手术，3例因青光眼需要再次手术。两组Kaplan-Meier生存曲线在统计学上相似，有结膜推进术组更优的趋势（P = 0.44）。