传统外路小梁切开术治疗原发性开角型青光眼的临床观察  

Clinical observation of traditional Ab-externo-trabeculotomy for primary open angle glaucoma

作　　者：陈志祺 程炳 姚可 周雄武 Chen Zhiqi;Cheng Bing;Yao Ke;Zhou Xiongwu(Department of Ophthalmology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,湖北武汉430030

出　　处：《加速康复外科杂志》2022年第4期165-168,共4页JOURNAL OF ENHANCED RECOVERY AFTER SURGERY

摘　　要：目的:评价传统外路小梁切开术治疗原发性开角型青光眼患者的临床疗效。方法:本研究为回顾性病例研究。2016年5月至2021年10月华中科技大学同济医学院附属同济医院眼科接受传统外路小梁切开术治疗原发性开角型青光眼的患者15例(15眼),术后随访6个月至6年时间不等,对比分析术前及术后末次随访的眼压、使用降眼压药物数量等,观察术中及术后并发症,分析其临床疗效。结果:15例患者,其中11例患者在末次随访时眼压均得到有效控制,术后平均随访时间(33.1±23.8)月,术前平均眼压(28.00±10.41)mmHg,术后末次随访的平均眼压为(15.37±2.42)mmHg(P=0.001),术前使用抗青光眼眼药水平均数量为(2.1±1.2)种,术后减为(0.6±0.5)种(P=0.001)。其余4例患者手术后1个月眼压未见明显下降,术后1个月左右再次行小梁切除术后眼压控制正常。所有患者术中均有不同程度的前房积血,术后早期可能因为前房积血有眼压一过性升高的情况,远期未见明显并发症。结论:借助小梁切开刀的传统外路小梁切开术是治疗原发性开角型青光眼的一种简便、安全、有效的治疗方式,可供临床医生参考选择。Objective:To evaluate clinical efficacy of traditional Ab-externo-trabeculotomy in the treatment of primary open angle glaucoma.Method:Retrospective case study.From May 2016 to October 2021,Tongji Hospital,Huazhong University of Science and Technology,15 cases(15 eyes)of primary open-angle glaucoma patients received traditional Ab-externo-trabeculotomy,the follow-up period ranged from 6 months to 6 years.The intraocular pressure(IOP)and the number of antihypertensive drugs used before and the last follow-up after operation were compared and analyzed,the intraoperative and postoperative complications were observed and the clinical efficacy was also analyzed.Result:The IOP was effectively controlled in 11 patients at the last follow-up,the average follow up was(33.1±23.8)months.The mean IOP was(28.00±10.41)mmHg before operation and(15.37±2.42)mmHg after operation(P=0.001).The mean number of anti-glaucoma eye drops used before operation was(2.1±1.2)while the postoperative was(0.6±0.5)(P=0.001).The IOP of the other 4 patients did not decrease significantly after operation,and about one month after operation the IOP was controlled after another trabeculectomy.All patients had anterior chamber hematoma of varying degrees during operation.IOP may rise temporarily in the early postoperative period because of anterior chamber hematoma,but no significant complications were observed in the long term.Conclusion:Traditional Ab-externo-trabeculotomy with trabeculotome is a simple,safe and effective treatment for primary open-angle glaucoma,which can be used as a reference for clinicians.

关 键 词：外路小梁切开术 原发性开角型青光眼 眼压 

分 类 号：R779.6[医药卫生—眼科]