单纯性非穿透小梁手术的临床观察

The clinical observation of simple non-penetrating trabecular surgery

本文对 10例 13眼开角青光眼患者行单纯性非穿透小梁手术联合术中应用丝裂霉素 C,术后观察眼压、眼内反应、滤过泡情况 ,并对 4例 5眼分别于术后 2 2、 44、 86及 96天行手术区超声生物显微镜检查。随访时间最短 35天 ,最长 180天。结果 :眼压 :术前 13眼平均眼压 36 .2± 13.3mm Hg,13眼术后 1周平均眼压为 8.5± 3.7mm Hg,1个月眼压 15 .7± 5 .7mm Hg,9眼术后 2个月眼压 16 .3± 5 .6 mm Hg,7眼术后 3个月眼压 15 .0± 4.0 mm Hg,3眼术后 4个月眼压 13.0± 4.4mm Hg,4眼术后 5个月眼压 18.5± 3.3mm Hg,均较术前明显下降。UBM检查可见结膜组织疏松 ,减压腔存在 ,巩膜至脉络膜通道疏松。术中及术后均未出现浅前房、前房出血、玻璃体脱出、脉络膜脱离等并发症。结论 :单纯性非穿透小梁手术能安全、有效地降低眼压 。

To evaluate the short term clinical effect of non penetrating trabecular surgery (NPTS) with mitomycin C in primary open angle glaucoma (POAG).Methods:13 eyes of 10 patients with POAG were underwent NPTS with mitomycin C during operation.The postoperative intraocular pressure (IOP),inflammation,filtering bleb and complications were analyzed.Five eyes of 4 patients were underwent the examination of ultrasound biomicroscopy (UBM) on the operative area in 22,44,86 and 96 days respectively after the operation.The follow up time ranged from 35 days to 180 days.Results:The mean intraocular pressure of 13 eyes was 36 2±13 3mmHg before operation.After operation,the mean IOP was 8 5±3 7mmHg in 1 week (13 eyes),15 7±5 7mmHg in 1 month (13eyes),16 3±5 6mmHg in 2 month (9 eyes),15 0±4 0mmHg in 3 month (7 eyes),13 0±4 4mmHg in 4 month (3 eyes),and 18 5±3 3mmHg in 5 month (4 eyes).All of the IOP decreased postoperatively.The examinations of UBM showed that the conjunctival tissue was loose,the transparent liquid space exised,and the drainage sites of sclera to choroid were loose.There was no complication such as flat anterior chamber,hyphema,vitreous loss and choroidal detachment existed during operation or after operation.Conclusion:NPTS with mitomycin C could decrease IOP effectively and safely.It is a promising technique to treat POAG.