外路小梁切开术和小梁切除术治疗原发性婴幼儿型青光眼的疗效比较

Extra trabeculotomy and trabeculectomy in treatment of primary infantile glaucoma

目的比较外路小梁切开术和小梁切除术治疗原发性婴幼儿型青光眼的疗效和并发症。方法将１９９２年１月至１９９６年６月间分别实施这两种术式的年龄基本匹配的两组患者进行比较，其中外路小梁切开术组３０例（５１只眼），小梁切除术组２６例（４６只眼）。结果外路小梁切开术组出院时成功率为９２．２％，平均随访２６．３个月，成功率为８７．５％。小梁切除术组出院时成功率为７３．９％，平均随访２８．１个月，成功率为６２．９％，两组比较差异有显著性（Ｐ＜０．０５）。外路小梁切开术组未见严重并发症发生，小梁切除术组有２只眼发生玻璃体脱出。结论外路小梁切开术以其高成功率和少而轻的并发症，明显优于小梁切除术，应作为治疗原发性婴幼儿型青光眼的首选术式推广。

Objective To compare the effectiveness and complication of extra trabeculotomy and trabeculectomy in the treatment of primary infantile glaucoma. Method Patients with primary infantile glaucoma and having undergone either of the two procedures from Jan, 1992 June,1996 were selected. Among them, group one (30 patients, 51 eyes) underwent extra trabeculotomy, while group two (26 patients, 46 eyes) underwent trabeculectomy. Results The success rates in group one were 92.2% at the time of discharge and 87.5% during follow up (mean 26.3 months); the rates in group two were 73.9% and 62.9% (mean 28.1 months) respectively, the differences being significant ( P <0.05). In group one, there was no severe complication, while in group two, two cases had vitreous prolapse. Conclusion Extra trabeculotomy is more efficacious and safer than trabeculectomy in the treatment of primary infantile glaucoma. It should be the first choice in the treatment of primary infantile glaucoma.