青光眼滤过术后影响滤过泡形成原因的临床分析

Clinical analysis of the factors related to the postoperative filtering bleb formation in anti-glaucoma filtering surgeries

目的 探讨青光眼滤过术后影响滤过泡形成的因素.方法 对2006年以来在我院行滤过手术并坚持随访1年以上的139名患者172眼的滤过泡形成情况进行统计分析.结果 本组患者术后1 a,Ⅰ型滤泡共61眼,占35.5%,Ⅱ型滤泡共89眼,占51.7%,Ⅲ型滤泡共15眼,占8.7%,Ⅳ型滤泡7眼,占4.1%.术后1 a,眼压8～16 mmHg者123眼,占71.5%,16～21 mmHg者36眼,占20.9%,大于21 mmHg者13眼,占7.6%;10眼大于正常值者中10眼通过按摩加药物的方法可以控制眼压在正常范围内;另外3眼通过2次手术将眼压控制在正常值以内.结论 青光眼滤过术后滤过泡形成主要与抗代谢药物的使用、手术技巧以及术后处理等因素有关.

Objective To investigate the factors related to the filtering bled formation in anti-glaucoma filtering surgeries. Methods The status of the filtering bleb in 139 patients （ 172 eyes） was analysed. All the patients received combined trabeculectomy in our hospital since 2006, and were followed up for more than 1 year. Results Type Ⅰ filtering bleb was observed in 61 eyes （35.5%）, type Ⅱ filtering bleb in 89 eyes （51.7%） ,type Ⅲ filtering bleb in 15 eyes（8.7% ） ,type Ⅳ filtering bleb in 7 eyes （4.1%） after followed up for 1 year. The status of intraocular pressure （IOP） at postoperative 1 year：8 ～ 16 mmHg in 123 eyes （71.5%）, 16 ～ 21 mmHg in 36 eyes （ 20.9% ）, more than 21 mmHg in 13 eyes （7.6%）. The IOP was controlled by eyeball massage and medicine in 10 eyes. One more surgery was done in 3 eyes. Conclusion The filtering bleb formation in anti-glaucoma filtering surgeries was related with the use of antimetabolite,surgery technique,and correct postoperative attendence.