非穿透性小梁切除联合周边虹膜切除术治疗原发性闭角型青光眼

Nonperforating trabecular surge-ry combined with iridectomy peripheral for the treatment of primary angle-closure glaucoma

目的观察非穿透性小梁切除联合周边虹膜切除术治疗原发性闭角型青光眼的临床效果。方法对15例18眼原发性开角型青光眼患者行非穿透性小梁切除联合周边虹膜切除术，术中应用丝裂霉素C，术后观察视力、前房反应、眼压、滤过泡情况，随访6月。结果15例18眼术前眼压23．3-48．7mmHg，平均（36．8±11．6）mmHg（1kPa=7．5mmHg）。术后1d（6、2±2．6）mmHg（4、2～8．3mmHg），术后1周（7．3±3、5）mmHg（4、6～10、8mmHg），术后2周（9．6±4、2）mmHg（8．2～14、0mmHg），术后1月（12．7±4．7）mmHg（8、5～15、6mmHg），术后2月（11．5±4．2）mmHg（8．0-14．8mmHg），术后3月（12、2±4．4）mmHg（8．0～16．2mmHg），术后4月（11、9±4．6）mmHg（8．0～15．8mmHg），术后5月（12．3±5．4）mmHg（8．2～17．7mmHg），术后6月（14．6±6．1）mmHg（8．5～20．7mmHg）。术后视力均达到或高于术前水平。18眼均有功能型滤泡。术中、术后均未出现浅前房及前房炎症反应。1例术中少量前房出血，于术后第1d全部吸收。结论非穿透性小梁切除联合周边虹膜切除术能安全、有效地治疗原发性闭角型青光眼。

Objective To observe the clinical effect of nonperforating trabecular surgery （NPTS） combined with iridectomy peripheral in primary angle-closure glaucoma. Methods Eighteen eyes of 15 patients with primary angle-closure glaucoma were performed with NPTS combined iridectomy peripheral and mitomycin C （MMC） during operation. The visual acuity, intraocular pressure （IOP）, inflammation and filtering bled were observed after surgery. Results The mean IOP of 18 eyes was （36.8± 11.6） mmHg（ 1 kPa = 7.5 mmHg） before operation. After operation, the mean IOP was （6.2 ± 2.6） mmHg in 1 day, （7.3±3.5） mmHg in 1 week,（9.6± 4.2） mmHg in2 weeks,（12.7 ± 4.7） mmHg in 1 month,（11.5 ± 4.2） mmHg in 2 months, （ 12.2 ± 4.4） mmHg in 3 months, （11.9 ± 4.6） mmHg in 4 months, （ 12.3 ± 5.4） mmHg in 5 months, （ 14.6 ± 6.1 ） mmHg in 6 months. Visual acuity improved or remained stable in 18 eyes after operation. All of these cases had effective filtering bled. There was no flat anterior chamber, inflammation existed during and after operation. Hyphema occurred in only 1 eye during operation and disappeared whinin 1 day. Conclusion NPTS combined with iridectomy peripheral is a effective and safe treatment for primary angle-closure glaucoma.