青光眼引流器植入联合小梁切除术治疗难治性青光眼的临床观察

Clinical observation of glaucoma drainage implants combined with trabeculectomy for the treatment of refractory glaucoma

目的观察青光眼引流器植入联合小梁切除术治疗难治性青光眼的疗效。方法对34例(46只眼)难治性青光眼行青光眼引流器植入联合小梁切除术治疗,观察术后视力、眼压、滤过泡及并发症等情况。结果34例难治性青光眼中,新生血管性青光眼12例(17只眼),无晶状体眼4例(4只眼),人工晶状体眼1例(1只眼),外伤性青光眼2例(2只眼),发育性青光眼9例(12只眼),色素播散性青光眼2例(2只眼)。术前平均眼压(42.15±2.32)mm Hg,术后眼压控制30只眼,眼压部分控制7只眼,眼压失控9只眼,术后平均眼压(18.34±3.55)mm Hg,眼压有效控制率为80.43%。功能性滤过泡形成率67.39%,手术并发症较少。结论新型国产青光眼引流器植入联合小梁切除术治疗难治性青光眼疗效好,安全性高,术后并发症少,可以推广使用。

Objective To study the clinical effects of drainage implants combined with trabeculectomy on the treatment of refractory glaucoma. Methods hirty-four refractory glaucoma patients（ 46 eyes） were treated with drainage device implantation and trabeculectomy. Postoperative visual acuity,intraocular pressure,filtering bleb and complications were observed. Results Glaucoma causes among the patients included neovascular glaucoma（ n = 12,17 eyes）,traumatic glaucoma（ n = 2,2 eyes）,developmental glaucoma（ n = 9,12 eyes）,and pigment disseminated glaucoma（ n =2,2 eyes）. There were 4 aphakic eyes and 1 eye with intraocular lens. Average preoperative IOP was 42. 15 ± 2. 32 mm Hg. After surgery,the average IOP was 18. 34 ± 3. 55 mm Hg. IOP was well controlled in 30 eyes,partially controlled in7 eyes,and uncontrolled in the remaining 9 eyes,resulting an effective rate of 80. 43%. Functional bleb formation rate was67. 39%,with little complications. Conclusion The new native glaucoma drainage implantation combined with trabeculectomy is effective and safe for refractory glaucoma. Few complications were observed.