小梁切除术后不同眼压对管状视野晚期青光眼患者预后的影响

Effects of intraocular pressure on prognosis of advanced glaucoma with tubular visual field after trabeculectomy

目的观察小梁切除术后不同眼压(intraocular pressure,IOP)对管状视野晚期青光眼患者预后的影响。方法选择2009年1月至2011年12月于我院眼科确诊为晚期青光眼的患者42例(56眼),所有患者仅存中心10°以内管状视野,均行小梁切除术。检查记录术后即刻IOP及术后随访末期患者视力,并检测患者视野;根据术后眼压将患者分为3组:低IOP组(≤12mmHg,1 kPa=7.5 mmHg)、中IOP组(>12-18 mmHg)、高IOP组(>18 mmHg)。结果术后低IOP组16眼,IOP为(10.56±2.13)mmHg;中IOP组23眼,IOP为(15.21±1.96)mmHg;高IOP组17眼,IOP为(22.14±2.56)mmHg。三组患者术后视力较术前均有不同程度提高,其中低IOP组手术前后视力差异有统计学意义(P=0.003<0.05)。三组患者术后视野平均缺损值均有不同程度降低,其中低IOP组手术前后视野平均缺损值差异有统计学意义(P=0.020<0.05)。结论管状视野晚期青光眼患者小梁切除术后眼压低于12 mmHg有利于患者视野恢复,改善预后。

Objective To observe the effects of intraocular pressure （IOP） on prognosis of advanced glaucoma with tubular visual field after trabeculectomy. Meth- ods A total of 42 patients （56 eyes） with advanced glaucoma underwent trabeculecto- my in our hospital from January 2009 to December 2011 were chosen, and all patients had the tubular visual field within 10° around the center. IOP was measured after trabe- culectomy immediately, and the visual acuity and visual field at the final follow-up were recorded. Based on the postoperative IOP, all patients were divided into three groups： low IOP group （IOP≤12 mmHg, 1 kPa = 7.5 mmHg） ,moderate IOP group （ 〉 12 - 18 mmHg） ,high IOP group （ 〉 18 mmHg）. Results There were 16 eyes in low IOP group ,IOP was （ 10.56 ± 2. 13 ） mmHg, 23 eyes in moderate IOP group with （ 15.21 ± 1.96）mmHg,17 eyes in high IOP group with （22. 14 ± 2.56）mmHg. The postoperative visual acuity in three groups all increased, there was statistical difference between pre- operation and post-operation in low IOP group （P = 0. 003 〈 0.05 ）. The postoperative visual filed mean defect in three groups all decreased, there was statistical difference between pre-operation and post-operation in low IOP group （P = 0.020 〈 0.05 ）. Con- clusion The postoperative IOP within 12 mmHg of advanced glaucoma after trabecu- lectomy can promote the visual field recovery and improve the prognosis.