小梁切除术后无功能滤过泡患者眼压正常的机制探讨

目的初步探讨小梁切除术后无功能滤过泡患者眼压控制正常的机制。方法对小梁切除术后无功能滤过泡,但眼压控制正常的16名患者进行包括一般眼科检查、UBM检查及前房角镜检查,寻找可能的房水排除途径。结果所有16只眼为瘢痕型滤过泡,虹膜周切孔通畅;UBM检查滤过泡区域未发现结膜瓣及巩膜瓣下潜在腔隙;前房角镜检查全部患者内滤过口阻塞、房角开放均>1/2周。结论小梁切除术后无功能滤过泡但眼压控制良好眼可能并不存在特殊的房水引流途径,其原因多是由于术前对患者的手术方式选择不当或手术适应症掌握不当。

Mechanism search for the patients whose intraocular pressure controlled well with non-functioning filtering blebs after trabeculectomy

Objective To primarily explore the mechanism of the patients whose intraocular pressure (IOP) controlled well with non-functioning filtering blebs after trabeculectomy. Methods 16 patients whose IOP controlled well with non-functioning filtering blebs after trabeculectomy were underwent general clinical examination, ultrasound biomicroscopy (UBM) of sclerectomy site and gonioscopy. And explore the possible outflow pathway of aqueous. Results All eyes were scarred blebs with unobstructed hole of peripheral iridectomy; no finding of potential liquid space both subconjunctival and under scleral flap by UBM; and full obstruction of deep sclerectomy, semi-quadrant functional open of anterior chamber angle were found by gonioscopy. Con- clusion There perhaps is no special pathway of aqueous outflow in the eyes with non-functioning filtering blebs but with well controlling IOP. It is approximately caused by the inappropriate way of surgery or inappro- priate choose of indication.