复合式小梁切除术在基层医院的应用

Application of complex trabeculeetomy for primary glaucoma in basic level hospital

目的观察复合式小梁切除术治疗青光眼的效果。方法原发性青光眼59例（63眼）采用复合式小梁切除术，即在传统小梁切除术的基础上增加预置前房穿刺、术中丝裂霉素c的应用及可拆除调节缝线。术后随访3个月一1年，观察视力、眼压、滤过泡、前房及并发症情况。结果术后眼压控制较好，全组63眼中，眼压≤21mmHg61眼，滴降眼压药后眼压I〉21mmHg者2眼。功能性滤过泡形成者61眼。前房形成快，术后1d轻度浅前房3眼，以复方托品卡胺滴眼后，恢复正常。未出现前房积血、滤过泡渗漏、低眼压或脉络膜脱离等术后并发症。结论复合式小梁切除术操作简便，创伤小、并发症少。

Objective To observe the therapeutic efficacy of complex trabeculectomy for primary glaucoma in basic level hospital. Methods Sixty-three eyes of 59 cases of primary glaucoma accepted com- plex trabeculectomy, based on the traditional trabeculectomy , increased the application of preseting anterior chamber paracentesis and mitomycin C in surgery and adjustable suture. And then follow-up three months to one year after surgery to oberve the visual acuity,lOP, bleb, anterior chamber and complications. Results Good lOP control in all subjects （63 eyes）, IOP of 61 eyes were less than or equal to 21 mm Hg,and 2 eyes were more than 21 mm Hg after using medicines of dropping down IOP. The functional bleb formed in 61 eyes. And rapid formation of the anterior chamber could be gotten after surgery, the mild shallow anterior chamberion 3 eyes a day after operation, with Compound Tropicamide Eye Drops trentment eye recovered to normal. Some complications have decreased, such as shallow anterior chamber, hyphema , bleb leakage, low IOP and choroidal detachment . Conclusions Complex trabeculectomy should be widely applied in basic level hospital because of simplicity of operator, minor trauma, more security and less complications.