小梁切除术中深层巩膜切除效果的临床观察

目的评价小梁切除术中增加深层巩膜切除治疗青光眼的疗效。方法对不同类型的青光眼采用了深层巩膜切除的小梁切除术(A组)36例46眼,其中原发性急性闭角型青光眼26例32眼,原发性开角型青光眼6例10眼,继发性青光眼4例4眼。并与我院传统小梁切除术(B组)33例46眼进行对比。术后观察眼压、前房、滤过泡及视力,随访时间1年。结果术后眼压≤21 mmHg(1 mmHg=0.133 kPa)者,A组42眼(91.30%),B组28眼(60.87%)。前房:A组44眼于术后3~4天完全形成,2眼发生浅前房(4.35%),经药物处理后7天形成;B组16眼发生不同程度的浅前房(34.78%)。滤过泡:功能性滤过泡A组44眼(95.65%),B组28眼(60.87%)。视力:A组提高者28眼,不变者16眼,减退者2眼;B组提高者16眼,不变者23眼,减退者7眼,两组差异有统计学意义。结论传统的小梁切除术中增加深层巩膜切除可减少术后浅前房的发生,控制眼压的效果更好。

Clinical observation of deep-layer sclerotica removal of trabeculectomy

Objective To evaluate the curative effects of trabeculectomy plus deep-layer sclerotica removal in glaucoma.Methods 36 patients with different type of glaucoma were treated with trabeculectomy plus deep-layer sclerotica removal(group A,46 eyes),among them 26 ones(32 eyes) were primary acute angle-closure glaucoma,6(10 eyes) primary open-angle glaucoma and 4(4 eyes) secondary glaucoma,and compared with 33 patients receiving traditional trabeculectomy in our hospital(group B,46 eyes).after operation,ocular tension,atria,col-bubble and vision were observed and followed up for 1 years. Results Post-operation ocular tension < or :21 mmHg were 42 eyes(91.30%) in the group A and 28 ones(60.87%) in the group B;in the group A,atria of 44 eyes completely formed within 3-4 days after operation,2 ones formed shallow of anterior chamber(4.35%) and did atria after 7 day medication;in the group B,16 eyes developed different extent of shallow of anterior chamber(34.78%);44 eyes had functional col-bubble in the group A(95.65%) and 28 eyes did in the control group(60.87%);in the group A,visions of 28 eyes improved,16 didn't change and 2 decreased: in the group B.16 improved,23 didn't change and 7 decreased,differerence showed statistictional significance between the 2 groups. Conclusions Traditional trabeculectomy plus deep-layer sclerotica removal can decrease the development of post-operation shallow of anterior chamber and effects of controlling ocular tension is better.