针刺分离及针拨断线并结膜下注射5-Fu治疗青光眼术后早期无滤泡的高眼压

目的 探讨针刺分离及针拨断线并结膜下注射5-Fu,治疗青光眼术后早期无滤泡的高眼压患者的治疗效果.方法 对18例18只眼青光眼术后早期无滤泡的高眼压患者采用针刺分离巩膜瓣下粘连及针拨断线并结膜下注射5-Fu进行治疗.结果 11例一次针刺分离并断线,4例两次针刺分离并断线,3例即刻失败.后进行了6～18月的随访,以不用降眼压药物眼压6-21mmHg为成功标准,6个月随访时(除外3例失败),10例不用药眼压<21mmHg,2例用1～2种降眼压药,1例3种降眼压药控制,2例再手术;12个月随访时8只眼不用药<21mmHg,3只眼1～2种,2只失访;治疗前平均眼压(29.4±9.4)mmHg,治疗后6个月平均眼压(14.5±5.7)mmHg,治疗前后差异有统计学意义(P<0.01).结论 对青光术后无明显滤过泡的患者采用针刺分离及针拨断线并结膜下注射5-Fu治疗安全有效.

Needle revision and suture cut combined with subconjunctival injection with 5-FU for treatment of earlier postoperative non-filtering blebs with high IOP

Objective To investigate the efficacy of bleb needle revision and suture cut with 5-FU subconjuctival injection near the bleb in reviving earlier non-filtering blebs with high lOP after glaucoma filtra-tion surgery. Methods Eighteen eyes of earlier non-filtering blebs with high lOP after glaneoma filtration surgery were treated with the technique of bleb needle separating adherence and cutting the suture of seleral flap with 5-FU subconjuctival injection near the bleb. Results Eleven eyes needed only once needle revision and suture cut,4 eyes repeated the therapeutics and 3 eyes failed at once. With 6-month follow-up,the IOP of 10 eyes were below 21 mmHg without any anti-glancoma drugs, 2 eyes needed adding 1-2 kinds of anti-glaucoma drugs, 1 eye needed 3 kinds of drugs,and 2 eyes needed re-operation to control the IOP below 21mmHg.With 12-month follow-up,the IOP of 8 eyes were below 21mmHg without any anti-glaucoma drugs,3 eyes needed adding 1-2 kinds of anti-glancoma drugs,2 eyes without follow-up. The mean IOP was 29.4±9.4mmHg before the treatment and that was 14.5±5.7mmHg after 6 months of the treatment,the difference was significant (P< 0.01 ). Conelusion It is safe and effective to treat earlier non-filtering blebs with high IOP after glaucoma filtration surgery with needle revision and suture cut combined with subconjunctival injection with 5-Fu, and it can be used as the routine method to treat the complication of earlier non-filtering blebs with high IOP.