小梁切除联合Schlemm管外壁切开术治疗青少年型青光眼早期效果的观察  

Observation on the early efficacy of trabeculectomy combined with incision of outer wall of Schlemm’s canal for the treatment of juvenile glaucoma

作　　者：张园园[1] 董敬民[1] Zhang Yuanyuan;Dong Jingmin(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Henan Provincial Ophthalmic Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院眼科河南省眼科医院,450052

出　　处：《中华眼外伤职业眼病杂志》2020年第1期12-16,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的观察小梁切除联合Schlemm管外壁切开术治疗青少年型青光眼的早期效果。方法收集郑州大学第一附属医院2016年9月至2019年2月青少年型青光眼共22例(34只眼)的临床资料进行回顾性分析。患者均进行小梁切除联合Schlemm管外壁切开术,术后随访6个月。结果手术前后视力(logMAR)差异无统计学意义(t=-0.544,P=0.590)。术后各时间点平均眼压均较术前下降,差异均有统计学意义(P<0.05)。术后21只眼(61.76%)形成功能性滤过泡。术后6个月完全成功者34只眼,占79.41%,部分成功者4只眼,占11.76%,手术成功率为91.18%(31/34)。术后1天,34只眼眼压均≤21 mmHg(1 mmHg=0.133 kPa);术后1个月,3只眼眼压升高,给予降眼压药物治疗后正常;术后6个月,7只眼眼压升高,应用降眼压药物后眼压正常,其中3只眼有进一步视野及杯盘比损害。术中及术后均未出现严重并发症。结论小梁切除联合Schlemm管外壁切开术可有效控制青少年型青光眼的眼压,保护视功能。Objective To observe the early efficacy of trabeculectomy combined with incision of outer wall of Schlemm’s canal in the treatment of juvenile glaucoma.Methods The clinical data of 34 eyes of 22 cases with juvenile glaucoma from Sep.2016 to Feb.2019 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.All patients underwent trabeculectomy combined with incision of outer wall of Schlemm’s canal.The followed-up times was 6 months.Results There was no significant difference in visual acuity(logMAR)between before and after operation(t=-0.544,P=0.590).The average IOP decreased at each time point postoperatively,and the difference was statistically significant between before and after operation(P<0.05).Functional filtration blebs were formed in 21 eyes(61.76%)postoperatively.The complete success was in 27 eyes(79.41%)at 6 months postoperatively,and the partial success was in 4 eyes(11.76%).The success rate was 91.17%(31/34).At 1 day postoperatively,the intraocular pressure was≤21 mmHg in 34 eyes(1 mmHg=0.133 kPa).The intraocular pressure increased at 1 month postoperatively in 3 eyes.After treatment with ocular hypotensive drugs,IOP of them decreased to normal level.At 6 months postoperatively,the IOP increased in 7 eyes and decreased after treatment with ocular hypotensive drugs.There were 3 eyes with further visual field impairment and cup-to-disk ratio damage among 7 eyes.No serious complication during or after surgery occurred.Conclusion Trabeculectomy combined with incision of outer wall of Schlemm’s canal for the treatment of juvenile glaucoma can effectively control the IOP and protect visual function.

关 键 词：青光眼 青少年型 小梁切除术 切开术 外壁 Schlemm管 

分 类 号：R77[医药卫生—眼科]