非穿透小梁切除术治疗青光眼临床观察  

Non penetrating trabeculectomy in glaucoma

作　　者：方爱武[1] 瞿佳[1] 王勤美[1] 刘晓强[1] 徐明[1] 

机构地区：[1]温州医学院附属眼视光医院眼科,325003

出　　处：《中国实用眼科杂志》2002年第2期126-128,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的 :观察非穿透小梁切除术治疗青光眼的临床疗效。方法 :对 5 5眼 3 8例青光眼患者进行非穿透小梁切除术。在浅层巩膜瓣下 ,切除层间巩膜、Schlemm′s管 (内、外 )壁、近管小梁 ,使房水在不打开前房的情况下 ,从角巩膜小梁渗出 ,从而达到降低眼压的目的 ,部分患者术中联合应用丝裂霉素和 /或植入网状透明质酸。术前、术后 1、 2、 8、 15天 ,1、 2、 3月 ,以后每 3月进行视力、眼压、裂隙灯显微镜、检眼镜等检查。结果 :术前平均眼压 3 1 65± 12 81mmHg (1mmHg =0 13 3kPa) ,术后第一天平均眼压 6 78± 2 5 3mmHg ,经 3— 12月随访 ,最后随访眼压 12 40± 3 74mmHg ,仅 2眼术后前房积血 ,均没有出现术中、术后浅前房、炎症反应等并发症。结论 :非穿透小梁切除术是一种安全。Objective:To study the clinical effectiveness of non penetrating trabeculectomy. Methods:55 eyes of 38 patients with open angle glaucoma had been run non penetrating deep sclerectomy (NPDS).A superficial scleral flap was raised and a deep sclerectomy was performed in the scleral bed.Schlemm′s canal was opened and the dissection of the cornea was performed up to Descemet′s membrane,at which point aqueous percolated through the remaining trabeculo Descemet′s membrane.Vision acuity,intraocular pressure (IOP),slit lamp and fundus examinations were performed before and after surgery. Results:The mean preoperative IOP was 31 65±12 81 mmHg (1mmHg=0 133kPa).The mean postoperative IOP was 12 40±3 74mmHg at the end of follow up (3～12 months).Operative complications included perforation during operation in 13 patients.Except for 2 hyphemas,no postoperative complications occurred in all non penetrating patients. Conclusions:NPDS appears to provide reasonable control of IOP,with few complications.

关 键 词：非穿透小梁切除术 青光眼 临床疗效 青光眼滤过手术 

分 类 号：R775[医药卫生—眼科] R779.6[医药卫生—临床医学]