青光眼滤过手术成功要素的探讨

The succesful factors of glaucoma filtration surgery.

目的 探讨提高青光眼滤过手术成功率的措施。方法 采取6项措施:术前3天停用缩瞳剂,滴皮质类固醇滴眼液;仅做球周麻醉,不做结膜下注射,以减少出血机会;术后彻底止血,但避免重烧伤;制做三角形巩膜瓣;小梁切除位置在Schwalbe线之后0.5mm以内;术后早期进行眼球按摩。结果 86例113眼术后眼压均控制在正常水平,术后第1天前房即形成,随访仅1例2眼术后半月出现包裹性滤过泡;1例1眼术后10天缝线滑脱,经处理恢复正常,余所有病例未见并发症发生。结论 只要注意青光眼手术中的每个细节,是可以提高其手术成功率的。

Objective To investigate how to enhance the succesful rate of glaucoma filtration operation. Methods Take six following steps. Stoped using miotic three days before operation, had corticosteroid eye-drop locally; In order to reduce blood, only used eye socket anesthesia. Completely stoped bleeding during operation. Make triangle sclera valve with bottom width 5mm and height 4mm; Trabeculectomy ' s-cutting position was within 0. 5mm posterior to schwalbe line. Ocular massage in time after operation. Results In the 113 eyes of operation, all intraocular pressure were controlled to normal level. Two days after operation, anterior chamber formed. Only two eyes in one case had a package filtration bleb half a month after operation. One eye' s suture got away ten days after operation, but returned to mormal by treatment. All of the rest had no complication happened. Conclusion It is possible to enhance the successful operation rate if you handle the glaucoma operation in detail with care.