改良小梁切除术治疗青光眼的临床疗效

目的探讨改良小粱切除术治疗青光眼的手术方法以及临床效果。方法 82例(82眼青光眼患者,均采用改良小梁切除术治疗,术后随访1年,观察患者前房、眼压、视力、并发症情况。结果 82例(82眼)患者术后1 d前房开始形成,术后1~5 d, 14例患者出现Ⅱ度浅前房,经调整缝线后恢复。术后1周内眼压≥21 mm Hg(1 mm Hg=0.133 kPa) 10眼,眼压11~20 mm Hg 50眼,眼压6~10 mm Hg22眼,行眼球按摩, 77眼眼压维持在12~18 mm Hg, 5眼眼压≥21 mm Hg。术后视力保持不变29眼,提高1~3行50眼,视力下降2~3行3眼。术后前房出血5眼,虹膜睫状体炎3眼,经药物保守对症治疗1周内消退。结论改良小梁切除术治疗青光眼操作简便,创伤小,安全性高,临床疗效较好,减少手术并发症的同时保证了手术的成功率,值得在基层医院推广应用。

Clinical efficacy of modified trabeculectomy on glaucoma

Objective To discuss the surgical method and clinical effect of modified trabeculectomy for glaucoma. Methods A total of 82(82 eyes) cases of glaucoma were treated with modified trabeculectomy. The patients were followed up for 1 year to observe the anterior chamber, intraocular pressure, vision, and complications. Results 82 patients(82 eyes) developed anterior chamber at 1 d after operation, and 1-5 d after operation, 14 patients developed a Ⅱ degree shallow anterior chamber and recovered after adjusting sutures. The intraocular pressure was≥21 mm Hg(1 mm Hg = 0.133 kPa) in 10 eyes, 11-20 mm Hg in 50 eyes, 6-10 mm Hg in 22 eyes. With eye massage, the intraocular pressure was maintained at 12-18 mm Hg in 77 eyes and≥ 21 mm Hg in 5 eyes. The postoperative visual acuity remained unchanged in 29 eyes, increased by 1-3 lines in 50 eyes, and decreased by 2-3 lines in 3 eyes. Anterior chamber hemorrhage occurred in 5 eyes and iridocyclitis in 3 eyes, which resolved within 1 week after symptomatic treatment with conservative drugs. Conclusion The modified trabeculectomy is easy to operate with little trauma, high safety and good clinical effect, and it can reduce the complications of the operation and ensure the success rate of the operation. It is worth popularizing in primary hospitals.