原发性先天性青光眼患者长期手疗效比较分析、  

Long-term surgical results of primary congenital glaucoma

作　　者：杜绍林[1] 张秀兰[1] 朱晓红[1] 张海平[1] 

机构地区：[1]中山大学附属东莞东华医院,东莞523110

出　　处：《中国实用眼科杂志》2009年第11期1236-1239,共4页Chinese Journal of Practical Ophthalmology

基　　金：基金项目：广东省医学科研基金资助2009

摘　　要：目的评价原发性先天性青光眼患者长期手术疗效。方法对过去11年间（1997年9月至2008年9月）收入中山大学中山眼科中心首次行手术治疗，并能长期随访到的48例81只眼原发性先天性青光眼患者进行回顾性分析。结果所有患者在小梁切除术、小梁切开术与联合手术者问手术成功率无明显差异（P=0．492）；在随访超过4年者中：Kaplan—Meier分析显示行小梁切除术与联合手术者成功率曲线下降较平稳，其中联合手术者成功率曲线下降最缓慢，但小梁切开术曲线下降较明显（P=0．022）。结论长期随访（≥4年）能更好地评价原发性先天性青光眼术后长期临床疗效；三种手术方式治疗原发性先天性青光眼患者远期成功率均随着时间的延长而下降，但以联合手术组成功率曲线下降最缓慢，其次是小梁切除术组，小梁切开术组成功率曲线下降最明显。术后远期的手术成功率与术后患者随访的依从性相关，患者依从性好术后远期的手术成功率高。Objective To evaluate the long-term effects of surgical managements on primary congenital glaucoma.Methods Forty-eight cases （81 eyes） with PCG who underwent primary trabeculectomy, trabeculotomy, combined trabeculotomy and trabeculectomy （CTT） were retrospectively investigated.Results The difference in success rates among trabeculectomy, trabeculotomy and CTT at 1, 3, 6 and 9 years was not statistically significant （P=0.492）.However, in patients with more than 4 years follow-up, the curves of trabeculectomy and CTT declined more slowly than that of trabeculotomy under Kaplan-Meier survival analysis. Conclusions Long-term follow-up could better tell which surgical option was more effective.Compared with trabeculotomy, trabeculectomy and CTT could achieve higher success rates in long-term follow-up.Regular follow-up of compliance might improve successful surgical outcomes.

关 键 词：原发性先天性青光眼 小梁切除术 小粱切开术 小梁切开联合切除术 

分 类 号：R775[医药卫生—眼科] R683.42[医药卫生—临床医学]