角膜缘小切口小梁切除术的设计及临床观察

Clinical investigation on trabeculectomy with small incision in limbus corneae.

目的 探讨角膜缘小切口小梁切除术的方法并观察其治疗各型原发性青光眼的效果。方法 结膜止点切开 ,切口长 4.0mm ;角膜缘前界板层切开 ,切口长 3 .5mm ;角巩膜瓣下阶梯状小梁切除联合浅层巩膜切开及深层巩膜表面中部纵向电凝。对术后视力、眼压、滤过泡及手术并发症进行总结。结果 术后随访 6～ 42月 ,所有病例角膜上皮无损伤 ,角膜缘切口无渗漏 ,3 4例 ( 46眼 )中 43眼滤过泡扁平弥散 ,3眼滤过泡不明显 ,眼压平均为 ( 16.78± 4.3 8)mmHg( 1mmHg =0 13 3kPa)。结论 该手术方法操作简便、组织损伤小 。

Objective To investigate the surgery method of small incision trabeculectomy without Tenon's capsule incision in the patients with primary glaucoma and observe the clinical effect. Methods With 4.0mm incision in the termination of bulbar conjunctiva, lamellar incision was made in anterior demarcation limbus. We took echelon trabeculectomy combined with episclerectomy and longitudinal electrocoagulation in the surface of middle of deep sclera. Retrospective investigation was undergone in the vision , intraocular pressure, filtration bleds and complication after the surgery. Results The corneal epithelium were not injured and limbus incision were not induced diffusion in all patients. Filtration blebs of 43 eyes were lowlying, diffuse. Only 3eyes procedure failed to control IOP. The mean IOP was 16.78~4.38mmHg. Conclusion The surgery is easy to operate with less injury. It also reduce the accidence of cicatrization of filtering bleb and increase the successful rate of filtration surgery of glaucoma.