小梁切除术的疗效观察

OBSERVATION ON THE EFFECT OF TRABECULECTOMY

目的 :探讨小梁切除术的手术效果 ,包括前房形成情况 ,眼压 ,视力 ,术后并发症及处理方法。方法 :对 60眼 (5 0例 )不同类型的青光眼病人采用小梁切除术 ,同时术中前房预置穿刺 ,使用丝裂霉素 (MMC) ,巩膜瓣及结膜牢固缝合 ,加上术毕形成前房的方法 ,术后随访 1年 ,对其术后效果和并发症进行分析。结果 :术后 90 %眼压维持在 2 1mmHg以下 ,10 %需配合降眼压药将眼压控制在 3 0mmHg以下。两例发生结膜瓣创漏 ,仅有两例术后视力低于术前 ;两例发生脉络膜脱离 ,经处理后恢复。结论 :青光眼滤过手术后浅前房的发生率很高 ,本方法不仅减少了术后常见并发症 ,而且提高了病人早期视力。如果能在术后早期严密观察 ,及时处理滤过泡不良和低眼压等并发症 ,眼压均可恢复正常。

Objective:To study the effect of trabeculectomy,including IOP,anterior chamber,vision and managements of complications.Methods:60 eyes of 50 glaucomatous cases were underwent trabeculectomy,including paracentesis in advance,suturing of scleral flap and conjunctival flap,using MMC and forming anterior chamber as soon as finished operation.All cases were followed-up 12 months.Results:IOP of post-operation <21 mmHg (90%),2 cases occurred conjunctiva filtering,there were only two cases whose vision of post-operation lower than before;2 cases occurred detachment of choroid,but they recovered after they were managed with non-surgical therapy.Conclusion:The incidence of filtering operation causing shallow anterior chamber was higher.Our methods not only obviously decrease common complications after filtering operation but also increase the patient's vision in the early stage.If we can manage the complications of bad bleb and low IOP in time at post-operation,normal IOP can also be obtained.