小梁切除术治疗色素性青光眼的中远期疗效  

Medium-long-term efficacy of trabeculectomy in the treatment of pigmentary glaucoma

作　　者：刘晓瑛 沈蔚 Xiao-Ying Liu;Wei Shen(The Affiliated Hospital of Yunnan University(Yunnan Eye Hospital,the Second People s Hospital of Yunnan Province),Yunnan Eye Institute,Key Laboratory of Yunnan Province for Ophthalmic Disease Research,Yunnan Ophthalmic Disease Clinical Medical Center,Yunnan Eye Disease Clinical Medical Research Center,Kunming 650021,Yunnan Province,China)

机构地区：[1]云南大学附属医院(云南省眼科医院,云南省第二人民医院)、云南省眼科研究所、云南省眼科疾病研究重点实验室、云南省眼科疾病临床医学中心、云南省眼部疾病临床医学研究中心,中国云南省昆明市650021

出　　处：《国际眼科杂志》2023年第8期1380-1383,共4页International Eye Science

基　　金：云南省眼科疾病临床医学中心开放课题(No.YXZX-03)。

摘　　要：目的:观察小梁切除术治疗色素性青光眼的中远期临床效果。方法:回顾性分析2010-01/2022-09于云南大学附属医院行小梁切除术治疗的色素性青光眼患者38例51眼的临床资料。术后随访3~144mo,分析纳入患者的眼压、视力及屈光状态,记录并发症情况,评估手术疗效。结果:纳入患者术前平均使用降眼压药物种类2.90±0.12种,平均眼压18.89±7.40mmHg,术后3d, 1、3、6mo, 1a、末次随访时平均眼压分别为14.68±5.08、13.99±2.95、14.25±2.50、14.36±2.83、14.33±2.66、14.94±1.95mmHg,术后各时间点眼压均较术前明显降低(P<0.05),术后各时间点眼压均无明显差异(P>0.05)。随访期间,纳入患者视力基本保持稳定,均无眼内炎、恶性青光眼发生。末次随访时,手术完全成功率为90%,部分成功率为8%,失败率为2%。结论:小梁切除术治疗色素性青光眼可以解除反向瞳孔阻滞,有效控制眼压、稳定视力,是安全有效的治疗方法。AIM:To observe the medium-long-term efficacy of trabeculectomy in the treatment of pigmentary glaucoma(PG).METHODS:The clinical data of 38 patients(51 eyes)who were diagnosed with PG and received trabeculectomy at the Affiliated Hospital of Yunnan University from January 2010 to September 2022 were retrospectively analyzed.The postoperative follow-up ranged from 3 to 144mo.The intraocular pressure(IOP),visual acuity and refractive status were analyzed,complications were recorded and surgical efficacy was evaluated.RESULTS:The average preoperative use of IOP lowering drugs was 2.90±0.12,with a mean IOP of 18.89±7.40mmHg.The IOP at 3d,1,3,6mo,1a after surgery and the last follow-up visit were 14.68±5.08,13.99±2.95,14.25±2.50,14.36±2.83,14.33±2.66,14.94±1.95mmHg,respectively,and postoperative IOP was significantly lower at all time points than that before surgery(P<0.05),while there was no significant difference at all time points after surgery(P>0.05).During the follow-up period,the visual acuity of all patients was stable,and no endophthalmitis or malignant glaucoma occurred.At the last follow-up,the complete success rate was 90%,the qualified success was 8%,and the failure rate was 2%.CONCLUSION:Trabeculectomy is a safe and effective treatment method for PG,which can effectively control the IOP,and stabilize the visual acuity and relieve the reverse pupil block.

关 键 词：小梁切除术 色素性青光眼 色素播散综合征 激光周边虹膜切除术 虹膜透照 

分 类 号：R779.6[医药卫生—眼科]