无固定缝线联合小梁切除术在闭角型青光眼中的临床应用.docVIP

精品论文 参考文献 无固定缝线联合小梁切除术在闭角型青光眼中的临床应用 张畅（辽宁省盘锦市第二人民医院眼科 124010） 【中图分类号】R779.6 【文献标识码】A【文章编号】1672-5085（2013）08-0118-02 【摘要】 目的 探讨采用无固定缝线进行小梁切除术治疗青光眼的临床效果。方法 2010年1～12月在我院确诊并进行手术治疗的闭角性青光眼患者共30例37眼，采用复合式小梁切除术。术后根据眼压及前房情况适时拆除可调缝线。结果 30例37眼青光眼患者术后随访结果如下：术后滤泡情况：术后随访1周，I型滤泡共4眼，占10.81%，II型滤泡共31眼，占83.78%，III型滤泡共2眼，占5.41%，未见有IV型滤泡。术后前房情况：术后观察1周以内出现浅前房的眼数为4眼，均为I级，未见II、III级浅前房者，经过加压包扎，阿托品散瞳后，一般2～4天均形成前房。术后眼压情况：术后1周眼压稳定后，眼压7～15mmHg者有33眼，占89.19%，15～21mmHg者有4眼，占10.81%。随访1月，眼压在7～15mmHg者有28眼，占75.68%，15-21mmHg者有9眼，占24.32%，所有患者均根据自身情况按要求进行眼球按摩。结论 小梁切除术中无固定缝线应用治疗青光眼，可有效的降低眼压，减少并发症发生，并有效促进功能性滤过泡的形成而提高青光眼的手术成功率。 【关键词】青光眼 小梁切除术 无固定缝线 Clinical observation of the trabeculectomy to treat glaucoma without anchor suture 【Abstract】 Objective To investigate the clinical effect of trabeculetomy to treat glaucoma without anchor suture.Methods 30 patients (37 eyes) underwent trabeculectomy from January 2008 to December 2010 in our hospital. The adjustable sutures were taken out based on the depth of anterior chamber and intraocular pressure(IOP).Result Morphologic characteristics of postoperative filtering bleb: the filtering blebs were divided into 4 types based Krofeldrsquo;s standards. I type blebs were observed in 4eyes(10.81%), II type blebs in 31 eyes(83.78%),III type blebs in 2 eyes(5.41%), and no IV type blebs after followed for 1 year.Status of postoperative anterior chamber: Shallow anterior chamber were observed in 4 eyes during 7 days after surgery, and are in I grade,The depth of anterior chambers were recovered in 2 to 4 days after pressure dressing and pupil dilation by atropine eye drop.Status of postoperative IOP: After a week of steady intraocular pressure, 7～15mmHg in 33 eyes(89.19%),15～21mmHg in 4 eyes(10.81%). After a month , 7～15mmHg in28 eyes(75.68%), 15-21mmHg in9 eyes(24.32%). All of the patients according to oneself circumstance as required eye massage. Conclusions The trabeculectomy without anchor suture can lower IOP, Reduce the complications，form func