前房穿刺与调节缝线联合丝裂霉素在青光眼小梁切除术中的应用

The Application of Paracentesis of Anterior Chamber and Adjustable Suture Combined with Mitomycin in Glaucoma Trabeculectomy

目的 探讨前房穿刺与调节缝线在青光眼小梁切除术中的应用及疗效。方法采用前房穿刺与调节缝线小梁切除术对26例急性闭角型青光眼、18例慢性闭角型青光眼、6例开角型青光眼、7例难治性青光眼共57例77眼进行了6个月至18个月的随访观察。结果术后视力较术前提高1～2行者4眼，术后视力不变67眼，下降1～2行6眼；出院时眼压平均在12．26mmHg左右，两周平均眼压为13．26mmHg左右，6～18个月眼压平均为15．69mmHg左右。无一例术后出现持续性浅前房。结论前房穿刺与调节缝线联合丝裂霉素行小梁切除术能有效地降低眼压，控制术后浅前房，提高了手术成功率，是一种安全有效的青光眼滤过手术方法。

Objective To explore the application and curative effect of paracentesis and adjustable suture in trabeculectomy. Methods A follow up for six to eighteen months observation was carried out for total 57 cases （77 eyes） who had trabeculectomy with paracentesis and adjustable suture which include 26 cases of acute angle-eloseure glaucoma, 18 cases of chronic angle-elosure glaucoma,6 cases of open-angle glaucoma,7 cases of refractory glaucoma. Results Four eyes had post-operative visual acuity increased by 1-2 lines; 67 eyes had no improvement in visual acuity; the post-operative visual acuity of 6 eyes was decreased by 1-2 lines. The average intraocular pressure was about 12.26 mmHg by the time of discharge; it was about 13.26 mm Hg at two weeks of post-operation and it was about 15.69 mm Hg 6-18 months of post-operation. There was no case developed durative shallow anterior chamber. Conclusion Paracentesis of anterior chamber and Adjustable Suture combined with Mitomyein could effectively reduce intraoeular pressure, control post-operative shallow anterior chamber and improved surgical success rate. It is a safe and effective filtration surgery for glaucoma.