改良小梁切除术预防浅前房发生的效果

Clinical Effect of Modified Trabeculectomy to Prevcnl Shallow Anterior Chamber

目的 探讨改良小梁切除术治疗闭角型青光眼的疗效。方法 105眼原发性闭角型青光眼分为2组，观察组（A组）47眼施行改良小梁切除术，对照组（B组）58眼施行常规小梁切除术。两组主要临床参数相似（P〉0．05）。观察两组术后前房形成，眼压及滤过泡等情况。结果 术后1周内，A组发生浅Ⅰ级前房4眼，B组发生浅T级前房14眼，浅Ⅱ级前厉3眼，浅Ⅲ级前房1眼。两组间差异具有显著性（P〈0．05）。A组末次随访眼压控制在21mmHg（1mmHg=0．133kPa）以下者40眼，控制率为85．1l％，B组末次随访眼压控制在21mmHg以下者50眼，控制率为86．21％上。术后功能性滤过泡A组87．23％，B组86．21％，两组差异无显著性（P〈0.05）。结论 改良小梁切除术能有效地减少术后浅前房的发生，并能达到与常规小梁切除术同样的降眼压效果。

Objective To report the surgical outcome of modified trabeculec- tomy for angle closure glaucoma. Methods 105 eyes with primary angle closure glaucoma were divided into two groups： 47 eyes in study group （group A） underwent modified trabeculectomy while 58 eyes in control group （group B） underwent normal trabeculectomy. There were no significant statistical differences between two groups with respect to sex, mean preoperative IOP and depth of anterior chamber （P〉0,05）, After trabeculectomy, depth of anterior chamber, postoperative lOP, filtration blebs were followed up and compared in two groups. Results In the first week after operation, there were four eyes with sallow Ⅰ degree anterior chamber in group A while in group B 14 eyes with shallow Ⅰ degree anterior chamber, three eyes with shallow Ⅱ degree anterior chamber, one eye with shallow Ⅲ degree anterior chamber. Statistically, there was significant difference between two groups. In addition, the lOP values in 40 eyes were below 21 mmHg （85.11%）, and the mean postoperative lOP was （16±1） mmHg in group A. The lOP values in 50 eyes were below 21 mmHg （86.21%） and the mean postoperative lOP was （17±2） mmHg in group B. The success rate of functional filtering blebs was 87.23 % in group A and 86.21% in group B. There was no significant statistical difference between two groups （P〉0.05）. Conclusion Modified trabeculetomy could effectively reduce the occurrence of postoperative shallow anterior chamber and reach the same decreasing IOP level as normal trabeculectomy.