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目的:观察改良复合式小梁切除术治疗青光眼及其并发症。方法:对确诊为原发性青光眼的26例35眼患者随机分为观察组改良复合式小梁切除术(17眼)与对照组单纯小梁切除术(18眼)进行观察分析,随访6～12(平均9.8)mo。结果:手术前后眼压情况:术前观察组54.37±6.30mmHg,对照组45.71±6.59mmHg;术后7d,观察组13.18±1.63mmHg,对照组13.33±2.11mmHg;术后6～12mo,观察组14.24±1.63mmHg,对照组19.33±2.14mmHg。观察组术后第1d前房形成15眼(88%),Ⅰ度浅前房1眼,Ⅱ度浅前房1眼,术后浅前房占12%(2/17)。对照组术后第1d前房形成8眼(44%),Ⅰ度浅前房6眼,Ⅱ度浅前房2眼,Ⅲ度浅前房2眼,浅前房共占56%(10/18)。6～12mo观察组中88%(15/17)为功能性滤过泡。对照组中56%(10/18)为功能性滤过泡。结论:复合式小梁切除术明显地提高了手术的成功率,减少术中、术后并发症,是一种理想的手术方法。
Objective: To observe the improved composite trabeculectomy for glaucoma and its complications. Methods: Twenty-six patients (35 eyes) diagnosed as primary glaucoma were randomly divided into observation group (modified composite trabeculectomy group, 17 eyes) and control group, trabeculectomy (18 eyes) 12 (average 9.8) mo. Results: The intraocular pressure before and after surgery was 54.37 ± 6.30mmHg in the observation group and 45.71 ± 6.59mmHg in the control group, 13.18 ± 1.63mmHg in the observation group and 13.33 ± 2.11mmHg in the control group at 7 days after operation. The observation group 14.24 ± 1.63mmHg and 19.33 ± 2.14mmHg in the control group. In the observation group, 15 eyes (88%) formed anterior chamber at 1 day postoperatively, 1 degree shallow anterior chamber, 1 shallow second anterior chamber, and 12% (2/17) shallow anterior chamber. In the control group, 8 eyes (44%) formed anterior chamber on day 1 postoperatively, 6 eyes had Ⅰ degree shallow anterior chamber, 2 eyes Ⅱ superficial anterior chamber, 2 eyes Ⅲ superficial anterior chamber and 56% 18). 88% (15/17) of 6 ~ 12mo observation group were functional filtering bleb. In the control group 56% (10/18) were functional bleb. Conclusion: Combined trabeculectomy significantly improves the success rate of surgery and reduces intraoperative and postoperative complications, which is an ideal surgical method.