改良式小梁切除联合深层巩膜切除术

Modified trabeculectomy combined with deep sclerectomy

小梁切除术一直是最为经典的抗青光眼手术,也是适应证最广、降眼压幅度最大的外滤过性手术代表。根据小梁切除术的降眼压机制及其术式改良的演变与发展,本文在既往各种术式改良的基础上,总结了一种较为优化的术式——小梁切除联合深层巩膜切除术。此术式发挥了多种引流机制、降眼压幅度大、可有效避免滤过泡相关远期并发症;手术适应证与小梁切除术相同,更适合于中晚期青光眼患者;操作简单、易学;术后并发症相对较少。(眼科,2022,31:175-180)

Trabeculectomy has always been the most classic anti-glaucoma surgery,and it is also the representative of external filtration surgery with the widest indications and the largest reduction of intraocular pressure(IOP).According to its mechanism of IOP control and history for improvement,the authors summarize and put forward a more optimized modification-modified trabeculectomy combined with deep sclerectomy.This modified surgery reduces IOP with large amplitude through a variety of mechanisms,and can effectively avoid the long-term complications related to filtering bleb at the same time.The surgical indications are the same as trabeculectomy,and is more suitable for patients with advanced glaucoma.The surgical procedures are easy to learn and postoperative complications are relatively rare.(Ophthalmol CHN,2022,31:175-180)