非穿透性小梁手术治疗青少年型青光眼的疗效分析

The clinical effect of non-penetrating trabecular surgery for treatment of juvenile glaucoma

目的评价非穿透性小粱手术治疗青少年型青光眼的临床疗效。方法对20例(30只眼)青少年型青光眼患者采用非穿透小梁手术,联合应用抗代谢药物和可调节缝线。术后随访观察眼压、视力、滤过泡、杯/盘比值、视野及术后并发症。结果患者术后l周和末次随访时(术后6～24个月)的眼压与术前相比显著下降,经配对t检验,其差异有统计学意义(分别为t=13.10,P<0.01和t=10.35,P<0.01)。所有患者随访期间视力均达到或略优于术前。术后不用或使用5-Fu形成功能性滤过泡,杯/盘比值和视野无明显进展。结论非穿透性小梁手术联合术中、术后应用抗代谢药物及可调节缝线,对于青少年型青光眼的降眼压效果明显,并且安全性高,应作为青少年型青光眼的首选手术治疗方式之一。

Objective To evaluate the clinical effect of non-penetrating trabecular surgery （NPTS） for the treatment of juvenile glaucoma. Method NPTS with anti-fibroblastic drugs and controlling sutures was performed on 30 eyes of 20 patients with juvenile glaucoma. Intraocular pressure （IOP） , visual acuity, filtering conjunctival bleb, cup/disc ratio, visual field and postoperative complications were following up for 6 to 24 months after operation. Results Mean IOP of 1 week post-operation and the end of the follow-up were significantly lower than that of pre-operation according to paired-sampies t test （ t = 13.10, P 〈0.01 andt =10.35, P 〈0.01）. All patients achieved the same or better visual acuity as pre-operation finally. Conclusion NPTS with anti-fibroblastic drugs and controlling sutures can effectively lower the IOP. NPTS should be one of the best choices for the treatment of patients with juvenile glaucoma, with few complications.