小梁切开术治疗先天性青光眼

目的探讨小梁切开术中Ｓｃｈｌｅｍｍ管如何定位，提高小梁切开术的成功率。方法由外集合管断端进入Ｈａｒｍｓ小梁切开刀，行小梁切开术，对３８例（４６只眼）先天性青光眼进行治疗和观察，其中３７只眼随访时间在６个月以上。结果眼压、杯盘比值，术前与随访结果对比，差异有显著性（Ｐ＜０．０５）；而角膜横径、前房深度、眼轴长度，差异无显著性（Ｐ＞０．０５）。２７只眼（７３．０％）眼压≤２．８ｋＰａ（１ｋＰａ＝７．５ｍｍＨｇ），青光眼控制良好。结论在行小梁切开术中，由外集合管径路进入Ｓｃｈｌｅｍｍ管，可较好地确定Ｓｃｈｌｅｍｍ管的位置。该方法简单、安全，具有一定的临床应用价值。

Treatment of congenital glaucoma with trabeculotomy

OBJECTIVE: To investigate the method of localization of Schlemm's canal during trabeculotomy to evaluate the successful rate of trabeculotomy. METHOD: The author treated 38 cases (46 eyes) of congenital glaucoma with trabeculotomy. Harms trabeculotomy knife was introduced into the Schlemm's canal through the cutting end of an external collecting channel. The follow-up period was over 6 months in 37 eyes. RESULTS: The intraocular pressure, C/D ratio were significantly improved after surgery compared to the preoperative ones (P < 0.05). But no significant differences were found in the corneal diameter, the depth of the anterior chamber, the length of ocular axis before and after surgery (P > 0.05). The intraocular pressure of 27 eyes (73.0%) was less than or equal to 2.8 kPa (1 kPa = 7.5 mmHg), showing good control of glaucoma. CONCLUSION: During trabeculotomy, the trabeculotomy knife introduced in to the Schlemm's canal through an external collecting channel is a better and accurate method of localization of Schlemm's canal. The method is relatively simple, reliable and has certain value in clinical application.