非穿透性小梁切除巩膜植入治疗青光眼的观察

Application of sclera implant in non-penetrating trabeculectomy for treating open-angle glaucoma.

目的 观察非穿透性小梁切除加自体巩膜植入治疗开角型青光眼的效果。方法 在浅层巩膜瓣下 ,做 3mm× 2mm之深层巩膜瓣 ,深度为保留睫状体上的一薄层巩膜组织 ,将此层巩膜剪下捆扎成细卷状并植入在原切除床上。观察术后视力、视野、眼压等改变。结果 36例 45眼术后视力提高 2行以上占 1 5 6% ,眼压控制在 1 0 9～ 2 0 1 4mmHg(1mmHg=0 1 33kPa)。随访 6月至 2 4月 ,眼压控制在 1 2 0 1～2 0 33mmHg。术后无浅前房或低眼压等并发症出现 ,视野未再缩小。结论 用巩膜做植入物 ,手术简便、安全、效果可靠 。

Objective To study the efficiency of sclera implant in non penetrating trabeculectomy for open angle glaucoma.Methods Under the superficial scleral flap,a 3 mm×2 mm deep sclera flap was cut with a thin layer scleral tissus was left,through which reflection of ciliary body can be seen,and wrapped.Then the wrapped scleral flap was implanted under the superficial flap. Visual acuity,visual field and intraocular pressure(IOP) were observed postoperatively.Results Visual acuity improved after operation in 15.6%,IOP was 10.9～21 14 mmHg.Following up for 6-24 months,IOP was 12.01 20.33 mmHg.No other complications,such as shallow anterior chamber,low intraocular pressure, were found after operation.Visual fields were not found deteriorated.Conclusion The operation with scleral implant in non penetrating trabeculectomy is safe,simple,perfect,and worth spreading.