青光眼滤过性手术失败50例临床分析  

A clinical observation of failing glaucoma filter in 50 cases

作　　者：周旌[1] 郭疆[1] 司马晶[1] 

机构地区：[1]广东省深圳市第二人民医院眼科,518035

出　　处：《临床眼科杂志》2008年第5期436-438,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨青光眼滤过性手术失败的原因及治疗方法。方法回顾分析2002年至2006年我科收治的青光眼滤过性手术失败的患者50例(53只眼)临床资料,包括年龄、性别、青光眼类型、首次手术方式、术后眼压升高时间、再次手术方式和手术部位等。结果50例(53只眼)患者中,男性25例(27只眼),女性25例(26只眼);年龄17～77岁,平均48岁;其中年龄≤20岁者4例,年龄21～40岁者18例,≥40岁者28例。首次手术方式中,单纯小梁切除术50只眼,非穿透小梁切除术2只眼,前房引流物植入术1只眼。手术失败原因中,滤过道外阻塞25只眼,滤过道内阻塞20只眼,非穿透小梁手术后滤过量不足2只眼,恶性青光眼1只眼,小梁切除术后滤过量不足4只眼,玻璃体阻塞引流导管1只眼。其中,有40只眼行再次手术,主要术式为复合式小梁切除术、前房引流物植入术和激光睫状体光凝术等,术后随访6个月,有35只眼的眼压控制在6～21mmHg,手术成功率为87.5%。结论对滤过手术失败的病例,术前准确分析手术失败的原因,选择合适的手术方式和手术部位,再次手术仍可获得理想的手术效果。Objective To analyze the causes of failing glaucoma filter and the effects of second surgery. Methods 50 patients （ 53 eyes ） with failing glaucoma filter in our hospital from 2002 to 2006 were selected. The clinical data were collected, including age, sex, types of glaucoma, pattern of first surgery, causes of failing surgery, pattern of second surgery and so forth. Results In the study, male 25 cases （27 eyes ）, female 25 （26 eyes ）, age 17 -77 years （ mean, 48 years）. In first surgery, trabeculectomy 50 eyes, non-penetrate trabeculectomy 2 eyes, drainage implantation 1 eye. And the main causes of failed surgery include outside obstruct of filtrate 25 eyes, inside obstruct of fdtrate 20 eyes , insufficient filtration after non-penetrate trabeculectomy 2 eyes , malignant glaucoma 1 eyes, insufficient filtration after trabeculectomy 4 eyes, vitreous block drainage 1 eye. 40 eyes accepted the second surgery. After 6 months of second surgery, IOP （ intraocular pression） of 35 eyes were controlled within 6 - 22mmHg. Conclusion With clarified causes of first surgery, proper operation pattern and position, second surgery of failed fihering surgery is safety and effective.

关 键 词：青光眼 手术 失败 

分 类 号：R779.6[医药卫生—眼科] R775[医药卫生—临床医学]