青光眼小梁切除术后高眼压拆线方法降眼压的探讨

The practical suture lysis methods for high intraocular pressure after trabeculectomy

目的探讨青光眼小梁切除术后高眼压拆线降眼压的方法及疗效。方法青光眼标准小梁切除手术后滤过泡扁平或失败、高眼压患者,经眼球按摩或/加调整缝线拆除后滤泡仍不隆起、眼压仍高者37例(44只眼),平均眼压(28.3+7.4)mmHg,采用一次性1ml注射器针头或显微剪拆线加分离联合眼球按摩,随访3～24月。结果35例(42只眼)眼压控制在正常范围,最后一次拆线处理3月后的眼压平均(16.4±3.5)mmHg。经t检验,眼压降低有统计学显著性意义(t=2.89,P<0.01),无严重并发症发生。结论一次性注射器针头或/和显微剪拆线加球结膜分离联合眼球按摩,是小梁切除术后失败患者简单、安全、有效和实用的拆线降眼压方法,适用于广大的基层医院。

Objective To investigate the suture lysis methods for high intraocular pressure (IOP) after trabeculectomy, which is simple, save, effective and practical in basal hospital. Methods We selected 44 eyes of 37 patients with high IOP and flattened or failed filtering blebs after trabeculectomy. All of the patients had undergone digital bulbus message and moderate suture removal. Their average IOP was (28.3±7.4)mmHg. All the cases were given suture lysis and /or separating (with microscissors or/and the needle attached to a 1.0 ml syringe for single use) combined with digital bulbus message within 6 weeks after operation. Followed up for 3 to 24 months. Results The IOP of 42 eyes of 35 patients achieved normal IOP. The average IOP 3 months after the last suture lysis treatment was (16.2±3.5)mmHg. The IOP reduction was significant statistically analyzed with t test (t=2.89, P<0.01). No serious complication was found. Conclusion The methods of suture lysis and /or separating (with microscissors or/and the needle attached to a 1.0 ml syringe for single use) combined with digital bulbus message is simple, save, effective and practical in basal hospital.