复合式三角形小梁翻转移位术治疗青光眼

目的 探讨复合式三角形小梁翻转移位术,治疗青光跟的临床效果.方法 对148例(156只眼)青光眼患者均在常规小梁切除术的基础上,0.05%丝裂霉素C棉片置于巩膜瓣下3min后用80ml生理盐水冲洗,对拟切除的包括小梁在内的深层巩膜组织(4mm×2.5mm×2.5mm)不完全切除.顶部有1mm巩膜未切,以其为蒂将其向后翻转,固定缝合于巩膜床上.术毕时前房注气形成前房.术后随访6～48个月.结果 156只眼中154只眼眼压<21mmHg,成功率97.4%,2只眼眼压在>21mmHg,失败率2.6%.结论 采用复合式三角形小梁翻转移位术治疗青光眼,能有效减轻术后滤过道阻塞,从而有效控制眼压,减少术后复发.该术式操作简单,且安全、有效.

Complexed turn-over transposition with triangular trabecule for the treatment of glaucoma

Objective To study the clinical effects of complexed turn-over transposition of triangular trabeculectomy on glaucoma.Methods Based on the 148 cases (156 eyes) of glaucoma patients who received conventional trabeculectomy, after 0.05% mitomycin C cotton sheet placed under the scleral flap for 3 minutes , then fully washed with saline.Trabecular meshwork and deep scleral tissue (4mm×2.5mm×2.5mm) was not completely removed.The top 1mm of sclera was not cut, but reversed to back, sutured in the sclera bed.Surgery was completed after air injection to form the anterior chamber.Postoperative follow-up was 6-48 months.Results The intraocular pressure was lower than 21mmHg in 154 eyes and higher than 21mmHg in 2 eyes.The success rate and failed rate were 97.4 % and 2.6 % respectively .Conclusions The modified turn-over transposition of triangular trabeculectomy is safe and easy to perform, can effectively relieve the postoperative blocking of the filtration canal, control postoperative IOP properly and reduce postoperative recurrence.