改良黏弹剂Schlemm管切开术治疗青少年型青光眼的临床研究

目的:观察改良的黏弹剂Schlemm管切开术治疗青少年型青光眼的疗效及安全性.方法:对被诊断为青少年型青光眼的27例43眼患者施行改良的黏弹剂Schlemm管切开术.记录患者的性别、接受该手术治疗时的年龄、是否有青光眼家族史、术前术后最佳矫正视力、青光眼药物使用情况、眼压及其它手术情况.记录具体手术步骤及术中术后是否发生明显的并发症.结果:改良的黏弹剂Schlemm管切开术治疗青少年型青光眼,术后2a的成功率为74%,术前平均眼压为35.38±7 15mmHg.2a后,患者平均眼压16.50±2.52mmHg,眼压下降值为18.88mmHg(P<0.01).术中及术后均未出现明显并发症.结论:长期随访的数据显示改良的黏弹剂Schlemm管切开术治疗青少年型青光眼有较好的临床效果,结合其术中、术后的并发症较少等优点,该手术有望成为青少年型青光眼的首选治疗术式.

Clinical study of modified viscocanalostomy for juvenile glaucoma

AIM:To report the surgical results of modified viscocanalostomy for patients with primary juvenile open angle glaucoma(JOAG).METHODS:The medical records of 27 patients(totally 43 eyes) with JOAG were reviewed to learn the results of modified viscocanalostomy for their glaucoma.Gender,age at initial modified viscocanalostomy,family history,corrected visual acuity,glaucoma medication used,surgical outcome duration of postoperative observation,preoperative and postoperative intraocular pressures(IOP) were reviewed.Complete success was defined as an IOP≤21mmHg,qualified success as IOP≤21mmHg with use of glaucoma medications,and failure as IOP >21mmHg despite medical therapy.The surgical technique used to perform the modified viscocanalostomy procedures was reviewed and the absence of significant complications noted.RESULTS:Complete success was achieved in 74% of the eyes over the two years follow-up period.Mean initial measures of IOP were 35.38±7.15mmHg.On the 24 months follow-up visit,the IOP was 16.50±2.52mmHg.The reduction of IOP was 18.88mmHg(P<0.01).No significant surgical complications occurred intraoperatively and posteperatively.CONCLUSION:Modified viscocanalostomy is a potentially effective initial surgical treatment of JOAG with a higher long-term success rate and fewer risks of postoperative complications.