滤过泡冷冻术治疗小梁切除术后巨大薄壁滤过泡的疗效

Effect of cryotherapy on large filtering bleb with thin wall after trabeculectomy

目的探讨滤过泡冷冻术治疗巨大薄壁滤过泡的安全性和疗效。方法采用滤过泡冷冻术治疗小梁切除术后滤过功能过强的巨大薄壁滤过泡14例16只眼。手术均在表面麻醉下进行，术后随访3～36个月，平均（24．4±11．1）个月。结果16只眼均顺利完成手术。术前眼压1～5mmHg，平均（3．25±1．13）mmHg；术后眼压5～14mmHg，平均（8．81±2．95）mmHg，手术前后眼压变化差异具有统计学意义（t=9．52，P=0．000）。手术前有7只眼存在黄斑水肿，手术后消失。术后有6只眼视力上升2行以上，手术前后视力差异具有统计学意义（Z=-2．226，P=0．026）。术后滤过泡无渗漏，无滤过泡感染等并发症。结论滤过泡冷冻术治疗巨大薄壁滤过泡具有手术时间短、简单易行、并发症少，疗效确切的优点。

Objective To evaluate the efficacy and safety of cryotherapy for large filtering bleb with thin wall. Methods Fourteen cases （ 16 eyes ） of large filtering bleb with thin wall underwent bleb cryotherapy,and were followed up for 3 ± 36 months （mean 24. 4 months ）. Results All of 16 eyes underwent the treatment smoothly with topical anesthesia. The surgery spent 5 ± 8 minutes （ mean 6. 2 minutes）. The intraocular pressure （IOP） preoperatively ranged 1 - 5 mmHg （3.25 ± 1.13 mmHg）, and postoperatively 5 ± 14 mmHg （8.81 ± 2.95 mmHg）. The difference was significant （t = 9. 52, P = 0. 000）. Macular edema occurred in 7 eyes preoperatively, and were cured postoperatively. Of all,6 eyes got a better visual acuity postoperatively, and there was a significant difference as compared to preoperation （Z = -2. 226, P = O. 026 ）. No severe complications such as bleb leakage, bleb rupture, ophthalmitis and intraocular hemorrhage were observed in all eases during surgery and postoperatively. Conclusions Bleb cryotherapy for large filtering bleb with thin wall is safe and effective. It has much advantage such as shot surgery time, simple, less complications ,safety and effective.