复合式小梁切除术在难治性青光眼治疗中的疗效观察.docxVIP

复合式小梁切除术在难治性青光眼治疗中的疗效观察 刘登忠(通讯作者)肖梅 邵阳市中心医院眼科422000 【摘 要】目的 观察复合式小梁切除术在难治性青光眼治疗中的安全和有 效性。方法 对2012年10月至2016年2月我科76例97眼不同原因所致的难 治性青光眼施行复合式小梁切除术，并辅以可调节缝线和眼球按摩治疗，观察术 后视力、眼压、滤过泡及并发症。结果 术后视力89眼稳定或提高，3眼绝对 期者无变化，5眼下降；术后7天、1月、3月、6月眼压与术前眼压比较差异有 统计学意义(Pt;0.05)o术后出现II级浅前房4眼，为结膜瓣渗漏所致，加压 包扎后恢复。术后前房出血6眼，为虹膜周边切除时少量血液进入前房有关，1 周内吸收。术后角膜水肿加重者3眼，与MMC流到角膜引起的毒性反应有关, 用药3-7天后水肿消退。结论 复合式小梁切除术辅以可调节缝线和眼球按摩治 疗难治性青光眼是安全有效的，可有效控制眼压，保护视功能。 【关键词】难治性；青光眼；复合式小梁切除术；可调节缝线；眼球按摩 Abstract Objective To observe the efficacy and safety of compound trabeculectomy in the treatment of refractory glaucoma. Methods Seventy?six patients (97 eyes) of different causes of refractory glaucoma in our department underwent compound trabeculectomy supplemented by sutures and eye massage from October 2012 to February 2015, Postoperative visual acuity, intraocular pressure, filtering bleb and complications were observed? Results.Eighty-nine visions were Stable or improved, 3 visions were not changed for absolute period glaucoma, 5 visions were droppedtraocular pressi on were dropped after 7 days 1 mon th、3 mon ths 6 mon ths and the differe nee was statistically sigrdf icant compared with preoperative IOP (Plt;0.05) . Two-degree shallow anterior chamber was appeared on 4 eye for conjunctival flap leakage and recoved by pressure bandage. Hyphema following a small amount of blood into the anterior chamber while peripheral iridectomy on 6 eyes was absorbed in 1 week. Corneal edema was aggravated on 3 eyes and related to MMC flows caused corneal toxicity and disappeared 3-7 days after the treatment. Conclusion Compound trabeculectomy supplemented by sutures and eye massage for refractory glaucoma is safe and effective, It can effectively control IOP and protect visual function. [Keywords] refractory； glaucoma； compo un d trabeculectomy； sutures； eye massage 难治性青光眼（refractoryglaucoma）是一大类各种原因所致的青光眼的总 称，如新生血管性青光眼、外伤性青光眼、先天性或发育性青光眼、行多次滤过 手术后的青光眼等等，降眼压药物治疗效果不佳，常规滤过性手术也常因滤过道 瘢痕化而导致手术失败。我科自2012年10月至2015年8月对76例97眼难治 性青光眼患者采用复合式小梁切除术治