改良小梁切除术治疗Ⅱ期新生血管性青光眼  

Treatment of stage Ⅱ of neovascular glaucoma with modified trabeculectomy

作　　者：柯秀峰[1] 袁鹂[1] 薛信君[1] 刘锦[1] 

机构地区：[1]南京医科大学第二附属医院眼科,南京210011

出　　处：《中国实用眼科杂志》2010年第5期518-520,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨改良小梁切除术治疗Ⅱ期新生血管性青光眼的疗效.方法 取30例（30只眼）Ⅱ期新生血管性青光眼行术中应用丝裂霉素C和可拆缝线的小梁切除术.术后早期,术眼眼压≥15mmHg和滤过泡扁平,拆除可拆缝线.术后观察眼压、滤过泡、并发症.随访12～48个月.结果 术前平均眼压（26.1±3.2）mmHg,最后一次随访时平均眼压（18.2 4±2.1）mmHg,两者之间差异有统计学意义（t=7.51,P〈0.01）.17只眼眼压〈21mmHg,眼压控制成功率为56.7%.6只眼眼压〉21mmHg,经局部应用降眼压药物后,眼压〈21mmHg.17只眼术后有Ⅰ型或Ⅱ型功能性滤过泡.术后4只眼（13.3%）在一周内有Ⅰ度浅前房,未经处理,自行恢复.术后12只眼（40.0%）有前房积血,10只眼前房积血在术后7d内吸收.2只眼在术后15d内吸收.无其他并发症.结论 改良小梁切除术能有效控制Ⅱ期新生血管性青光眼的眼压,术后无严重并发症,是一种安全、有效地Ⅱ期新生血管性青光眼的降眼压方法.Objective To explore the clinical results of combined trabeculectomy with mitomycin C and removable sutures for stage Ⅱ neovascular glaucoma.Methods Thirty patients （30 eyes） in stage Ⅱ neovascular glaucoma were treated with trabeculectomy combined with mitomycin C and removable sutures. In the early postoperative period, removable sutures were removed when intraocular pressure （IOP） ≥15 mmHg with a flat bleb.The postoperative IOP, blebs and complications were recorded.The follow-up ranged from 12 to 48 months.Besults The mean preoperative IOP was （26.1± 3.2） mmHg, the mean postoperative IOP was （18.2± 2.1） mmHg, the difference was statistical significant （t=7.51, P〈0.01 ）.If success was defined as IOP 〈21mmHg without medication, the success rate of surgery was 56.7%.There were functional blebs in 17eyes. The incidence of hyphema was 40%, shallow anterior chamber was 13.3%, no other complications were ob-served.Conclusions Trabeculectomy with mitomycin C and removable sutures for stage Ⅱ neovascular glaucoma can effectively control IOP and do not induce serious complications.It is a safe and effective method of controlling IOP in stage Ⅱ of neovascular glaucoma.

关 键 词：新生血管性青光眼 小梁切除术 

分 类 号：R775[医药卫生—眼科]