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目的 :评价小梁造瘘联合深层巩膜切除术治疗闭角型青光眼的疗效。方法 :对 16例 (16只眼 )闭角型青光眼患者实施了小梁造瘘联合深层巩膜切除术 ,术后观察视力、前房、房角、眼压及滤过泡变化。随访时间 6～ 15个月 ,平均 11 5个月。结果 :11只眼视力增加 2～ 4行 ,5只眼无变化。术后第 1天 12只眼前房形成 ,房角镜检查见巩膜条之间的房角开放 ,16只眼术后 7个月眼压均低于 15 75mmHg(1mmHg =0 133kPa) ,其中 2只眼术后 8个月眼压达 19 2 5mmHg ,16只眼结膜滤过泡弥散。 4只眼术后浅前房 ,其中 1例经B超证实为脉络膜脱离 ,给予局部滴类固醇眼药水、口服醋氮酰胺和加压包扎等处理后前房加深 ,脉络膜脱离复位。结论 :小梁造瘘联合深层巩膜切除术是一种安全可靠有效的抗青光眼手术。
Objective: To evaluate the efficacy of trabeculectomy combined with deep sclerectomy for angle-closure glaucoma. Methods: Sixteen patients (16 eyes) with angle closure glaucoma underwent trabeculectomy combined with deep sclerectomy. Visual acuity, anterior chamber, angle, intraocular pressure and filtration bleb were observed after operation. Follow-up time of 6 to 15 months, an average of 11 5 months. Results: The visual acuity of 11 eyes increased by 2 ~ 4 lines, while 5 eyes had no change. The anterior chamber was formed in 12 eyes on the first postoperative day, and the angle between the scleral strips was open in the gonocular examination. The intraocular pressure was lower than 15 75 mmHg (1 mmHg = 0 133 kPa) at 7 months after operation in 16 eyes, of which 2 Eight months after the operation, the intraocular pressure reached 19 2 5 mmHg, and 16 eyes conjunctiva filtered diffusely. Four eyes were treated with shallow anterior chamber. Among them, one case was proved to be choroidal detachment by B-mode ultrasound. Topical drops of steroid eye drops were given. After treatment with oral acetazolamide and pressure bandaging, the anterior chamber deepened and choroidal detachment was reset. Conclusion: Trabeculectomy combined with deep sclerectomy is a safe, effective and effective anti-glaucoma surgery.