青光眼小梁切除术后早期结膜切口漏治疗的临床观察  

Clinical observation on conjunctival incision leakage at early stage after trabeculectomy

作　　者：郭玉强 张清生 庞彦利 陈瑞强 Guo Yuqiang;Zhang Qingsheng;Pang Yanli;Chen Ruiqiang(Puyang Municipal Eye Hospital,Henan 457000,China)

机构地区：[1]濮阳市眼科医院,河南457000

出　　处：《中华眼外伤职业眼病杂志》2018年第9期673-675,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨青光眼小梁切除术后结膜切口漏的治疗方法及效果。 方法回顾性分析2012年6月至2017年12月小梁切除术后结膜切口漏67例（67眼）的临床资料，观察眼压、滤过泡情况。治疗后观察3～6个月。 结果67眼小梁切除术后切口漏均发生于术后1周内，眼压15～23 mmHg者9眼（13.4%）；10～14 mmHg者21眼（31.3%）；5～9 mmHg者37眼（55.26%）（1 mmHg＝0.133 kPa），出现浅前房43眼（64.2%）；脉络膜脱离17眼（25.4%），无眼内炎、睫状环阻滞性青光眼等严重并发症。治疗方法：采用加压包扎或碘酊烧灼保守治疗或（和）结膜重新缝合修复。眼压低于15 mmHg者23眼，15～20 mmHg者26眼，高于21 mmHg者18眼。 结论及时处理青光眼深切除术后结膜切口漏有利于减少严重的并发症，有利于功能滤过泡的形成，增加小梁切除术的成功率。ObjectiveTo investigate the treatment and efficacy of conjunctival incision leakage at early stage after trabeculectomy. MethodsThe data of 67 eyes of 67 cases with conjunctival incision leakage after trabeculectomy from Jun. 2012 to Dec. 2017 was retrospectively analysed. The intraocular pressure and filtering blebs were observed for 3-6 months. ResultsIncision leakage occurred in 67 cases at 1 week postoperatively, intraocular pressure was 15-23 mmHg in 9 eyes （13.4%）, 10-14 mmHg in 21 eyes （31.3%）, 5- 9 mmHg in 37 eyes （55.26%） （1 mmHg=0.133 kPa）. There were 43 eyes of shallow anterior chamber （64.2%）, choroidal detachment in 17 eyes （25.4%）. No other serious complication such as endophthalmitis or malignant glaucoma. The complications were treat with conservative treatment of pressure dressing or iodine burning, conjunctival resuture repair. The intraocular pressure was less than 15 mmHg in 23 eyes, 15-20 mmHg in 26 eyes, higher than 21 mmHg in 18 eyes. ConclusionThe timely and standardized treatment for the conjunctival incision leakage is beneficial to reduce the occurrence of more serious complications, and is conducive to the formation of functional filtering blebs. Thereby the success rate of trabeculectomy is improved.

关 键 词：小梁切除 结膜切口漏 临床观察 

分 类 号：R779.6[医药卫生—眼科]