改良型非穿透性小梁切除术远期临床效果观察

目的:研究改良型非穿透性小梁切除术治疗原发性青光眼的临床效果。方法:原发性青光眼21例30眼施行改良型非穿透性小梁切除术,切除小梁网和Schlemm管外壁组织1.0mm×3.0mm,保留最内层组织,于术后1wk;1,6mo;1a及5a以上(最长10a)观察临床效果。结果:早期随访不用抗青光眼药物眼压低于2.7kPa者28眼,有效率达93%,长期随访眼压低于2.7kPa者27眼,有效率达90%。术后无严重并发症发生。结论:改良型非穿透性小梁切除术在早期和平均5a随访中能有效降低原发性开角型和闭角型青光眼患者眼压,因不穿透前房而术后并发症少,是一种理想的原发性青光眼手术方法。

Long-term clinical effectiveness of reformed nonperforating trabeculectomy

AIM: To investigate the clinical effectiveness of reformed nonperforating trabeculectomy(NPT) in the patients with primary glaucoma. METHODS: 30 eyes of 21 patients with primary glaucoma patients underwent reformed NPT, in which 1.0mm.0mm out layer of trabecular meshwork with Schlemm's canal was excised, but the innermost tissue was reserved. The clinical effectiveness was observed with short-term follow-up (1wk;1,6mo) and the long-term follow-up (1a and over, 10a the longest). RESULTS: The intraocular pressure(IOP) was controlled in 28 eyes (93%) without anti-glaucoma medicine during short-term follow-up, and in 27 eyes(90%)for long-term ones. There were no serious post-operative complications in all cases. CONCLUSION: The elevated IOP in patients with primary glaucoma can be effectively reduced by reformed NPT during short-term and long-term follow-up. The post-operative complications are much less because of no intra-operative penetration of the anterior chamber. The reformed NPT is an ideal surgical procedure for primary glaucoma.