小梁切除术后影响功能性滤过泡的相关因素

Correlation factors affecting functional filter-bleb after trabeculetomy

目的 探讨抗青光眼小梁切除术后影响功能性滤过泡的相关因素。方法 分别对48例50眼青光眼小梁切除术后滤过泡失败患者的年龄、青光眼粪型、术前眼部情况（视力、视野、杯／盘及眼压）、术前用药情况以及所采取的手术方式和术后处理等做一回顾性分析。结果小梁切除术35眼。小梁切除术联合术中丝裂霉素应用15眼。术后无功能滤过泡发生在30～45岁者30眼（60％）；慢性开角性青光眼者26眼（52％）；34眼（68％）为晚期青光眼；16眼长期局部应用抗青光眼药物；8眼为高眼压下实施手术；11眼术后出现不同程度的葡萄膜炎症反应；24例未得到正确护理；结论 青光眼小梁切除术后功能性滤过泡的维持与手术方式、术前眼压状况、术前用药及术后处理等有关，与手术年龄、膏光眼类型、手术时机是否有直接关系有待进一步研究。

Objective To investigate the correlation factors affecting functional filter - bleb after trabeculetomy （antiglaucoma operation）. Methods A retrospective study was performed on the age, type of glaucoma, ocular sign （vision, visual field, C/D and intraocular pressure） pre operation, the usage of topical antiglaucoma drugs before operation, the form of operation and postoperative management in 50 eyes of 48 cases. Results Trabeculectomy and trabeculectomy with mitomycin C was performed on 35 and 15 eyes respectively. Failed filter bleb post - operation was found in 30eyes（60%）whose age were 39-45, 26 eyes（52% ）of chronic open angle glaucoma, 34 eyes（68% ）of glaucoma of advanced stage, 16 eyes droped topical antiglaucoma drugs for long time before operation, 8 cases with durative intraocular hypertension pre operation, 11 eyes with post operative uveitis, and 24 eyes without proper post operative care. Conclusions Failed filter- bleb after trabeculetomy was correlated with the form of operation, intraocular pressure preoperation, the usage of topical antiglaucoma drugs before operation and postoperative management. The relationship between failed filter- bleb and factors including age, type of glaucoma and time of operation should be studied further.