非穿透性小梁手术治疗继发性开角型青光眼  

Non-penetrating trbecular surgery in secondary open angle glaucoma.

作　　者：金晓红[1] 郭文毅[1] 孟樊荣[1] 孙兴怀[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《眼外伤职业眼病杂志》2006年第6期413-415,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的观察非穿透性小梁手术（NPTS）对继发性开角型青光眼的临床疗效及安全性。方法对37例（41眼）继发性开角型青光眼进行NPTS联合透明质酸生物胶植入或T-Flux植入术，对年轻患者术中联合丝裂霉素。术后观察眼压，眼内炎症反应情况，滤过泡形态，视力和视野进展情况。随访时间6～48月，平均（20．5±11．7）月。结果术前平均眼压为34．8mmHg，术后为19．1mmHg（包括失败眼），二者差异有统计学意义（P〈0．001）。手术完全成功率在术后12月、24月、36月时分别为78．9％，65．2％，60．3％；加上部分成功眼总成功率为86．7％，75．9％，75．9％。术中有5眼（15．1％）发生微穿孔，均植入T-Flux：术后有4眼出现轻微前房积血，均在5天内吸收；术中未出现玻璃体脱出、无前房、低眼压性黄斑病变或植入物移位等并发症。结论NPTS联合生物胶或T-Flux植入能有效降低眼压，术中、术后并发症少，是一种治疗继发性开角型青光眼安全有效的治疗方法。Objective To evaluate the success rate and complications of non-penetrating trabecular surgery（NPTS） in secondary open angle glaucoma. Methods NPTS with reticulated sodium hyaluronate implant （SK-GEL） or T-Flux implant was performed on 37 patients（41 eyes） with secondary open angle glaucoma. The postoperative intraocular pressure （IOP）, visual acuity, inflammation, filtering bleb, and visual field were analyzed. The mean follow up time was 20.5 ± 11. 7 months （range from 6 to 48 months）. The authors defined complete success as an IOP of 21 mmHg or lower without anti- glaucoma medications, quailfled success as an IOP of 21 mmHg or lower with medication, and failure as an lOP of more than 21 mmHg with medications, or the need for reoperation. Results The lOP decreased from a mean preoperative value of 34.8mmHg to a mean postoperative value of 19. 1 mmHg （ P 〈 0.001 ）.The cumulative probability of complete or qualified success was 78.9%,86.7% at 1 year; 65.2%, 75,9% at 2years and , 60.3%, 75,9% at 3 years. Micro - perforation happened in 5 patients who were all implanted with T-Flux. Postoperative complication included hyphema in 4 eyes. Conclusions NPTS with SK-Gel or T-Flux implant appears to provide reasonable control of lOP at medium term follow-up with few immediate postoperative complications in secondary open angle glaucoma.

关 键 词：继发性青光眼 非穿透性小梁手术 

分 类 号：R779.6[医药卫生—眼科]