小梁切除术后早期功能不良滤过泡治疗

Treatment of Early Dysfunctional Filtering Blebs after Trabeculectomy

目的观察青光眼小梁切除术后早期功能不良滤过泡的处理效果。方法对36例(36眼)小梁切除术后3～8 d 内功能不良滤过泡行眼球按摩和钝针头针拨分离治疗,所有患者术中曾用过0.3 mg/mL 的抗代谢药丝裂霉素 C(mitomycin-C,MMC)。随访6个月。结果经治疗后32眼为功能滤过泡,4眼为非功能滤过泡。治疗前平均眼压23.21±6.50 mm Hg(1 mm Hg=0.133 kPa),治疗后即刻为11.60±5.40 mm Hg,随访结束时平均眼压16.10±4.18 mm Hg,治疗前后眼压差异有统计学意义(P<0.001)。术中和术后无严重并发症。结论对早期功能不良滤过泡采用眼球按摩和钝针头针拨分离治疗,获得良好效果,可挽救濒临失败的滤过泡,此法操作简单、安全,并发症少。早期发现和早期治疗是成功的关键。(中国眼耳鼻喉科杂志,2007,7:174-175)。

Purpose To observe the therapeutic efficacy of treating early dysfunctional filtering blebs after glaucoma trabeculectomy. Methods Thirty-six eyes of 36 patients with glaucoma were included in this study. Eyeball massage and bleb needling with a blunt needle were performed for the treatment of failing filtering blebs 3-8 days after trabeculectomy with mitomycin-C. All the patients were followed up for 6 months. Results After massage and revision with bleb needling, the failing filtering blebs turned to be functional in 32 eyes and the blebs in the rest of the eyes ,remained dysfunctional. The average intraocular pressure （IOP） was 23.21 ±6.50 mm Hg （1 mm Hg = 0. 133 kPa） before treatment and 11. 6±5.40 mm Hg immediately after treatment, 16. 10 ± 4. 18 mm Hg 3 months after treatment. There was significant difference in IOP between pre-and post treatment eyes. No any severe complications were found during and after surgery. Conclusion Eyeball massage combined with bleb needling with a blunt needle is an effective and safe method to treat early dysfunctional blebs after glaucoma trabeculectomy. Early diagnosis and treating are the key points for successful treatment.