Schlemm管引流联合复合式小梁切除术治疗外伤性青光眼

The treatment of Schlemm's canal draining and trabeculectomy for t-raumatic glaucoma

目的探讨Schlemm管引流联合复合式小梁切除术治疗外伤性青光眼的可行性和疗效评价。方法对23例(23眼)因眼外伤房角后退继发开角型青光眼患者施行Schlemm管引流联合复合式小梁切除术,术后观察眼压、矫正视力、前房情况、术后并发症和滤过泡的形态等。术后随访6～24个月,平均(14.46±9.16)月。结果术后1 d、1周、1月、3月、6月、12月平均眼压分别为(8.7±3.19)mmHg、(9.14±4.62)mmHg、(13.62±3.10)mmHg、(13.77±4.11)mmHg、(14.55±6.02)mmHg、(15.98±5.12)mmHg。与术前平均眼压(31.73±8.66)mmHg比较差异均具有统计学意义(P均<0.05)。最末次随访平均眼压(16.41±4.25)mmHg,与术前平均眼压比较,差异具有统计学意义(t=13.547,P=0.000)。术后21眼眼压控制在正常范围,手术成功率91.30%。15眼(65.22%)形成功能性滤过泡,6只眼(26.09%)为非功能滤过泡,但眼压正常范围内。术后并发症主要是早期前房出血。结论Schlemm管引流联合复合式小梁切除术治疗外伤性青光眼安全有效,并发症少,具有良好临床应用前景。

Objective To evaluate the feasibility and curative effect of trabeculectomy combined with Schlemm＇ s canal draining for traumatic glaucoma. Methods Trabeeuleetomy combined with Schlemm＇ s canal draining was performed on 23 cases （23 eyes）with traumatic glaucoma. The intraocular pressure, corrected vision, formation and inflammatory reaction of the anterior chamber,complications and filtering bleD＇ s situation were examined postoperatively. The follow -up time was 6 -24 months, the average was（ 14.46 ± 9.16 ）months. Results The intraocular pressure （lOP） was （ 8.7 ± 3.19 ） mmHg, （ 9.14 ± 4.62 ） mmHg, （ 13.62 ± 3.10 ） mmHg, （ 13.77 ± 4.11 ） mmHg ,（ 14.55 ± 6.02 ） mmHg, （ 15.98 ± 5.12） mmHg at the first day, one week, one month, three months, six month, twelvemonth postoperative. The average preoperative IOP was （31.73 ± 8.66）mmHg. There were significant differences between the preoperative IOP and postoperative IOP. It had statistical significance（ P 〈 0.05 ）. The average IOP of last followup time was （16.41 ± 4.25 ）mmHg. Statistically significant difference was found between preoperative IOP and last follow - up time＇ s IOP（ t = 13. 547 ,P =0. 000）. The postoperative IOP was normal in 21 eyes, and the achievement ratio of the operation was 91.30%. There were 15 eyes （65.22%）with functional fihering bleD, and 6 eyes （26.09%）with unfunctional filtering bleD. The IOP was normal all. The main postoperative complications was hyphenm in the early stage. Conclusion The treatment of trabecu- lectomy combined with Schlemm＇ s canal draining for traumatic glaucoma was effective and safe. There was fewer postoperative complications. And the method had a wide clinical application and bright prospect.