包裹性滤泡及结膜下房水积存导致溢泪症的临床分析

Clinical analysis of encapsulated filtering bleb and lacrimation after trabeulectomy with paracentisis

目的观察穿刺术对复合小梁切除术后包裹性囊状滤泡及结膜下房水积存使泪小点堵塞而导致的溢泪症的疗效。方法对10例10眼复合性小梁切除术后近期形成的包裹性囊状滤泡及5例6眼复合性小梁切除术后形成的结膜下房水积存导致的溢泪症进行穿刺术。结果包裹性囊状滤泡:10例10眼穿刺次数1～4次,平均2次。自术前眼压平均(31.5±5.2)mmHg降至术后即刻眼压平均(11.5±3.3)mmHg。追踪观察期间可见滤泡扁平弥散,眼压稳定于21mmHg以下。结膜下房水积存导致的溢泪症:5例6眼中2眼穿刺2次,其余均只穿刺1次。穿刺处结膜下积液吸收或明显减少,结膜不再堵塞泪小点,溢泪症状消失。结论穿刺术是处理复合小梁切除术后包裹性囊状滤泡及结膜下房水积存导致的溢泪症的安全、有效的方法。

Objective To evaluate the efficacy of paracentisis on treating encapsulated bleb and lacrimation after trabeculectomy. Methods Encapsulated bleb： paracentisis was performed with a 26 - gauge tuberculin syringe on 10 eyes of 10 cases with encapsulated blebs following trabeculectomy. 2） lacrimation： paracentisis was performed with a 26 - gauge tuberculin syringe on 6 eyes of 5 cases, whose lacrimation were due to the aqueous humor store under the internal conjunctiva following trabeculectmy and so that the lacrimal punctum was obstructed by the cyst like conjunctiva. Results Encapsulated blebs： paracentisis was performed 1 - 4 times on the eyes （mean 2 times）. The mean intraocular pressure （IOP） was（31.5 ± 5.2）mmHg before the operation and it was （11.5 ± 3.3）mmHg right after the operation. All the blebs appeared dispersing and the IOP in all the eyes was lower than 21 mmHg during the follow- up period. 2） lacrimation： paracentisis was performed two times on two eyes and one time on the rest. The aqueous humor stored under the internal conjunctiva disappeared and the punctum was not obstructed after the operation. No complication was found except a case felt a short - term heart palpitation. Conclusion Paracentisis is an effective and safe method of management of encapsulated filtering bleb and lacrimation after trabeculectomy.