下方小梁切除术治疗青光眼滤过术后高眼压

Trabeculectomy performed inferiorly for high intraocular pressure after antiglaucoma filtering surgery

目的观察应用下方小梁切除术治疗25例(26眼)青光眼滤过术后高眼压的疗效。方法回顾性分析2005年1月至2007年12月25例(26眼)青光眼滤过术后眼压不降的原因、再次行下方小梁切除术的方法技巧及其临床效果。结果滤过泡瘢痕化是初次手术失败的最主要原因。患者术前眼压(33.26±15.35)mmHg,经过再次下方小梁切除术的治疗,滤过泡形成良好,眼压显著降低,术后第2天眼压(12.25±9.43)mmHg,第5天眼压(11.35±8.32)mmHg。术后3月后眼压(15.15±10.73)mmHg。结论下方小梁切除术应用于青光眼滤过术后的再次手术治疗,效果显著,可安全有效地降低眼压。

Objective To evaluate the surgical effects of trabeculectomy performed inferiorly for high intraocular pressure alter antiglaucoma filtering surgery. Methods The authors retrospectively reviewed the medical records of 25 cases（26 eyes） consecutive trabeculectomy at the inferior limbus from January 2005 to December 2007.The cause of high intraocular pressure after antiglaucoma surgery was analysed,and technique and clinic effect of the trabeculectomy at the inferior limbus was introduced. Results Scaring of filter bleb is main factor of failure alter initial surgery. Preoperative IOPs averaged（33.26±15.35）mmHg,All of the patients had undergone trabeculectomy at the inferior got well filter bleb;IOPs were marked dropped,Alter surgery,IOPs averaged（12.25±9.43）mmHg by the second day,and IOPs averaged（11.35±8.32）mmHg by the 5th day, IOPs averaged（15.15±10.37）mmHg by more than three month. Conclusion Trabeculectomy at the inferior limbus is marked curative effect for repeat the antiglaucoma surgery,IOPs can be dropped safely and effectively.