小梁切除术对青光眼预后的干预研究  

作　　者：张扬[1] 袁援生[1] 张帆[2] 

机构地区：[1]昆明医学院第一附属医院眼科,昆明650032 [2]昆明医学院第一附属医院耳鼻喉科,昆明650032

出　　处：《中国实用眼科杂志》2007年第4期378-381,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的研究小梁切除术（Trabeculectomy）后眼压下降超过50%的青光眼视野的改变。方法挑选小梁切除术后眼压下降超过50%的原发性青光眼80例110眼,其中原发性开角型青光眼（primary open angle glaucoma,POAG）32例50眼,原发性慢性闭角型青光眼（chronic angle-closure glaucoma,CACG）48例60眼。利用改良的HPA国际视野分期法（附表）根据术前视野将青光眼分为早、中、晚期后,追踪观察两型三期青光眼术后2年内三次检查的眼压、视野的变化;分析术前、术后眼压与视野的相关性;比较手术对两型不同时期青光眼的治疗效果。结果①两型早、中期青光眼术后视野好转,各指数变化有显著性差异（P〈0.05）,两型晚期青光眼术后视野稳定,各指数变化无显著性差异（P〉0.05）;②两型青光眼术前、术后眼压与视野指数呈正相关（P〈0.05）;③术后第1次视野改变在早、中、晚期青光眼之间有显著性差异（P〈0.05）,但视野改变在两型青光眼之间无显著性差异（P〉0.05）。结论小梁切除术后的眼压控制对青光眼预后起着积极的作用,而尽早手术更有利于青光眼视功能的恢复。Objective To investigating the changes of visual field in the glaucoma cases with a drop by over 50 percent after trabeculectomy. Method To select 80 cases with primary glaucoma （110 eyes） of which the intraocular pressure decreased by over 50 percent after trabeculectomy. There are 32 cases （50 eyes） with primary open-angle glaucoma （POAG） and 48 cases （60 eyes）with chronic angle-closure glaucoma （CACG） among them. After classify the glaucoma cases into early stage, moderate stage and severe stage by visual fields before operation with the Modified Hodapp-Parrish-Anderson Visual Fields Grading System, to compare the variations of the intraocular pressure and visual fields got from 3 examinations in 2 years after operations; to analyze the correlation between intraocular pressure and visual fields pre-operately and after-operately; contrast the therapeutic effects of operation to different stage glaucoma. Result 1. All indicators of visual fields of both early and moderate stage glaucoma in three examinations after operation are found to improve compared with those before operation with obvious turn to for the better（P〈0.05）. Compared with those before operation, there is not significant difference in all indicators inclusive of visual fields of two styles of severe stage glaucoma in three examinations after-operately （P〉0.05）. 2. Intraocular pressure of two-style glaucoma is in direct correlation with visual field factors （P〈0.05） pre-operately and after-operately; 3.There is significant difference in the first turn of visual field after operation among early-stage, moderate-stage and severe-stage glaucoma （P〈0.05） while without such significant difference of visual field turn between twO styles of glaucoma （P〉0.05）. Conclusion To control intraocular pressure after trabeculeetomy plays an active role in the prognosis of glaucoma and to cure patients as early as possible can contribute to the recovery of the visual function of glaucoma.

关 键 词：小梁切除术 青光眠 术前与术后 眼压 视野 

分 类 号：R775.2[医药卫生—眼科]