Molteno管植入术治疗角膜移植术后难治性青光眼

目的:研究Molteno管植入术治疗穿透性角膜移植术后继发青光眼的手术疗效。方法:对9例眼部条件极差,经最大剂量药物治疗不能降低眼压的穿透性角膜移植术后青光眼施行Molteno管植入手术。结果:7例眼压控制在0.8～2.8kPa(1kPa=7.5mmHg)之间,成功率为77.78％(7/9);另两例需继续局部滴用β-受体阻滞剂,1例发生角膜排斤反应经药物治疗痊愈,1例角膜半透明,角膜植片透明率88.89％(8/9),术后视力有改善者4例,视力保持不变者4例,视力下降者1例,其中4例最好矫正视力大于0.05。结论:Molteno管植入术为角膜移植术后保留一定有视力而又不具作滤过性手术条件的难治性青光眼提供合理、有效的治疗方法。眼科学报1999;15:107-110。

Implantation of the Molteno Tube for Refractory Glaucoma Following Penetrating Keratoplasty

PURPOSE: To assess the surgical effectiveness of the molteno tube implantation in glaucoma secondary to penetrating keratoplasty. METHODS: 9 eyes in critical condition with glaucoma secondary to corneal graft surgery, whose intraocular pressures (IOP) have previously failed to respond to glaucoma medication, were undergone Molteno tube implantation. RESULTS: IOPs ranged from 0.8-2.8 kPa (1 kPa = 7.5 mmHg) were obtained in 7 eyes, the success rate accounted for 7/9, 2 eyes still required installation of beta-blocker, the graft rejection occurred in one eye and was remedied with medical treatment, the graft remained half-transparent in one eye. Visual acuity improved in 4 eyes, stayed the same in 4 eyes and was worse in one eye. The best corrected visual acuity over 0.05 was recorded in 4 eyes. CONCLUSION: Moltemo tube implantation is a rational and effective method for preserving a certain level of visual acuity in patients with glaucoma following penetrating keratoplasty.