小梁切除术中巩膜瓣牢固缝合后按摩效果观察

Application of Eyeball Massage after Trabeculectomy with Scleral-flap Tight Suture

目的观察老龄组原发性青光眼小梁切除术中巩膜瓣牢固缝合，术后眼球按摩临床疗效。方法对46只原发性青光眼在常规小梁切除术的基础上，采用大结膜瓣，巩膜瓣牢固缝合，术后3～5d开始眼球按摩，坚持2～6月，观察术后早期前房形成、滤过泡及眼压情况，并随访1年以上的远期疗效。结果老年组术后早期均未出现低眼压、浅前房等并发症，眼球按摩后滤过泡形成良好，远期眼压均在正常范围。结论老龄组原发性青光眼小梁切除术中巩膜瓣牢固缝合，术后眼球按摩，可避免术后早期低眼压、浅前房等并发症，远期滤过道通畅，眼压控制良好。该方法简单易行，安全可靠，有一定实用价值。

Objective To observe the clinical effect of trabeculectomy with scleral-flap tight suture and postoperative eyeball massage to senile primary glaucoma. Methods 46 eyes with primary glaucoma were operated with standard trabeculectomy Using larg incision of conjunctiva-flap and scleral-flap tight suture. The time to massage eyeball was 3 -5 days after operation, keeping 2 -6 months. Anterior chamber depth,fitering bubble and intraocular pressure （lOP） were observed after operation. The followup time was over one year. Results There was no postoperative complications such as early low lOP and shallow anterior chamber. All cases obtained nice filtering bubble and long term normal IOP. Conclusions This surgery is suitable for the seniors who suffer from primary glaucoma. It can avoid complications such as ealy postoperative low lOP and shallow anterior chamber. Long term filtering tunnel were unblocked, lOP were well controlled. This method is easy,safe and practicality.