多通道房水引流术治疗晚期青光眼的研究进展  

Research progress of multichannel aqueous humor drainage surgery in treatment of advanced glaucoma

作　　者：焦可心 李亚文 赵敏[1] 闫晓伟 唐广贤 张恒丽 Jiao Kexin;Li Yawen;Zhao Min;Yan Xiaowei;Tang Guangxian;Zhang Hengli(Department of Ophthalmology,Shijiazhuang People’s Hospital,Shijiazhuang 050000,China)

机构地区：[1]石家庄市人民医院眼科,050000

出　　处：《国际眼科纵览》2023年第1期6-11,共6页International Review of Ophthalmology

摘　　要：多通道房水引流术通过Schlemm管、脉络膜上腔、深层巩膜池和结膜下滤过共同促进房水排出,降低眼压,同时减少了发生滤过泡相关并发症的几率,主要术式包括深层巩膜切除术(deep sclerectomy,DS)、CO_(2)激光辅助深层巩膜切除术(CO_(2) laser-assisted sclerectomy surgery,CLASS)、穿透性Schlemm管成形术(penetrating canaloplasty,PCP)以及微导管辅助的外路小梁切开联合深层巩膜切除和小梁切除术(microcatheter-assisted trabeculotomy with deep sclerectomy and trabeculectomy,MATT-DS-Trab),前两种术式保留了Schlemm管内壁,对前房干扰较少,后两种术式均联合切除了小梁网,克服了Schlemm管内外阻力,对不同类型早中期青光眼的治疗取得了较好疗效。晚期青光眼需要更低的目标眼压保护视功能、延长视力年,多通道房水引流术为晚期青光眼患者提供了个体化、精准化的治疗方案,提高手术成功率、降低青光眼盲的发生率。Multichannel aqueous humor drainage surgery through Schlemm canal,suprachoroidal space,deep scleral lake,and subconjunctival filtration jointly promotes aqueous humor outflow and decreases intraocular pressure(IOP),and reduce the incidence of bleb-related complications.The main operations include deep sclerectomy(DS),CO_(2) laser-assisted sclerectomy surgery(CLASS),penetrating canaloplasty(PCP)and microcatheter-assisted trabeculotomy with deep sclerectomy and trabeculectomy(MATT-DS-Trab).The first two surgical methods retain the inner wall of Schlemm canal and have less interference with the anterior chamber,while the latter two surgical methods combine the excision of trabecular mesh,which overcome the internal and external resistance of Schlemm canal,and achieve good efficacy in the treatment of early and middle glaucoma.Advanced glaucoma requires lower target IOP to protect visual function and prolong visual acuity.This multi-channel aqueous humor drainage surgery provides individualized and precise therapies for patients with advanced glaucoma,improve the success rate of surgery,and reduce the incidence of glaucoma blindness.

关 键 词：青光眼 多通道房水引流术 微创青光眼手术 

分 类 号：R775[医药卫生—眼科]