无结膜切口小梁切除术初步观察

A primary report of non-conjunctival incision trabeculectomy

寻找一种新的抗青光眼滤过手术。方法 从上方角膜缘内１ｍｍ处横行切开４ ｍｍ，深达１／２角膜厚度。再向巩膜方向分离至角膜缘后３ ｍｍ处，形成一巩膜袋。将袋的底部穿刺至结膜下，并将袋的底部巩膜切开一长约２ｍｍ×２ｍｍ的缺口，形成滤过道的外口。在角膜缘做常规小梁切除术，作为滤过道的内口。结果 １０例患者术后球结膜滤泡明显，眼压均控制在正常范围。结论 该手术方式是一种新的，有效的抗青光眼滤过性术式，避免了常规手术球结膜损伤所致滤过道瘢痕引起的手术失败。

Objective To search a new method of filtering surgery for glaucoma. Methods A 4mm incision upper corneal limbus 1mm was made,the incision was about 1/2 cornea depth. It was disassociated to 3 mm of post-corneal limbus on the sclera and formed a sclera bag. Through the base of the bag,we punctured to the subconjunctive and excised a little sclera at the base of the bag to form an external passge,regular trabeculectomy was operated at corneal limbus as an internal passage. Results There were 10 patiens with obviously filtering bleb of bulbar conjunctive after the operation and their ocular tensions was all controled at normal range. Conclusion This operation was a new and effective fitering surgery. It avoided the formation of fitering cicatrix which led to the operative failure.