巩膜咬切术联合小梁切开术治疗原发性青光眼的远期效果观察

Long-term effect observation of sclerectomy combind with trabeculectomy in treatment of primary glauco

目的探讨巩膜咬切术联合小梁切开术治疗原发性青光眼的远期疗效和并发症.方法随机选取2003年12月～2006年12月在本院住院的原发性青光眼患者25例（29只眼）,施行巩膜咬切术联合小梁切开术,观察比较术前、术后眼压及视力的变化.结果术后追踪观察36～84个月,平均眼压为（14.32±3.43）mmHg,低于术前的（38.33±5.36）mmHg,差异有统计学意义（P＜0.05）.手术后视力较术前明显提高,差异有统计学意义（P＜0.05）.本组病例术后5只眼发生角膜内皮线状混浊,前房少量出血,3只眼前房形成迟缓,2只眼术后28个月发生白内障,未发现低眼压、脉络膜剥离、黄斑囊样水肿、眼内炎等并发症.结论巩膜咬切术联合小梁切开术治疗原发性青光眼,不切除小梁,组织损伤少,术后并发症少,能维持正常眼压,提高视力.

Objective To investigate the long-term effect and complications of sclerectomy combined with trabeculecto- my in the treatment of primary glaucoma.Methods 25 cases （29 eyes） with primary glaucoma were selected in our hos- pital from December 2003 to December 2006,and were underwent sclerectomy combined with trabeculectomy.Results 36 to 84 months follow-up was taken,the intraocular pressure was （14.32±3.43） mm Hg,was lower than （38.33±5.36） mm Hg before treatment,the difference was significant （P〈0.05）.After operation,visual acuity was significantly improved compared with before operation,the difference was significant （P〈0.05）.After operation,5 eyes of corneal endothelial lin- ear opacities was occurred,hyphema were 3 eyes,anterior chamber formation was slow,2 eyes of cataract were occurred after 28 months treatment.There was no hypotony,choroidal detachment,macular cystoid edema.Conclusion Sclereetomy combined with trabeculectomy in treatment of primary glaucoma,not remove small beam,tissue damage is less,postoper- ative complication is less,can maintain the normal intraocular pressure,improve the visual acuity.