非穿透性小梁显微手术的远期疗效观察

目的探讨非穿透性小梁显微手术治疗青光眼的远期疗效。方法对原发性开角型青光眼患者共46例（46眼），随机选择施行非穿透性小梁手术（A组22例，22眼）或穿透性小梁手术（B组24例，24眼），比较两组患者术后的眼压、滤过泡和视野等情况。结果①术后观察近50个月，A组眼压有较明显升高的趋势，眼压控制完全成功仅为5眼（22．73％），失败7眼（31．82％）；B组完全成功11眼（45．83％），失败4眼（16．67％），但两组的差异无统计学意义（P〉0．05）；②术后所有B组患者均形成明显的功能性滤过泡；A组患者只有15眼（68．18％）形成明显滤过泡，3眼（13．64％）仅见滤床轻度隆起；随着时间的推移，两组患者滤过泡消失的例数显示出明显差异（P〈0．05）；③术后50个月的视野改变情况，A组视野缩小者例数为9眼（40．90％），B组为4眼（16．67％），但差异无统计学意义（P=0．068〉0．05）。结论施行非穿透性小梁手术的部分病例远期疗效欠佳，须谨慎选择适应患者，以提高手术成功率。

Long-term effects of non-penatrating trabecular surgery treating glaucoma

Objective To evaluate the long-term clinical effect of non-penetrating trabecular surgery (NPTS)for the treatment of primary open angle glaucoma(POAG). Methods A total of 46 patients(46 eyes) with POAG were observed retrospectively. 22 eyes and 24 eyes uderwent non-penetrating trabecular surgery (NPTS) and trabeculectomy surgery(TS). Intraocular pressure (IOP), filtration bleb and visual field were ob-served. Results ①In the follow-up of 50 month, there was a significant hypertendency in post-operative intraoc-ular pressure in NPTS group. The IOP was controlled successfully in 5 eyes(22. 73%) ,and 7 eyes(31.82%) were failure in NPTS group. 11 eyes(45.83%) were success,4 eyes(16. 67%) were failure in TS group, but there were no statistically significant differences between two groups(P > 0. 05). ②The ratio of sustained filtra-tion bleb of TS group after surgery is 100% ,the ratio of sustained filtration bleb of NPTS group after surgery is 15 (68.18%), while 3 eyes(13.64%)were flat filtrtion hleb. From the time passing by, there were statistically significant differences in the disappearance number of filtration bled between two groups (P < 0. 05). ③After 50 month ,9 eyes (40. 90%) were constriction of fields in NPTS group, while 4 eyes (16. 67%) in TS group, but there were no statistically significant differences between two groups (P = 0. 068 > 0.05). Conclusion Long-term effects of non-penatrating trabecular surgery treating glaucoma were indefinite in some cases. It is very im-portant to choose the suitable surgery to gain high success rate.