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目的观察改良小梁切除术治疗原发性开角型青光眼的疗效。设计回顾性、病例对照研究。研究对象原发性开角型青光眼患者41例(51眼)。方法本组病例随机分两组。试验组行改良小梁切除术,即切除一垂直巩膜瓣和小梁网,同时做周边虹膜切除和部分球结膜下的筋膜组织切除;对照组行传统小梁切除术。术后随访1年,观察眼压、视力、功能性滤过泡存留情况及并发症,比较两种手术方法的疗效。主要指标眼压、视力、功能性滤过泡及手术并发症。结果术后随访1年,试验组中 97．2％(25／26)的眼压低于21 mmHg,对照组则为76．0％(19／25)。术后最佳矫正视力两组无明显差别。术后两组均未发生严重并发症。结论改良小梁切除术较传统小梁切除术的长期眼压控制好,是治疗开角型青光眼安全有效的手术方式。
Objective To observe the therapeutic effect of modified trabeculectomy on primary open-angle glaucoma. Design retrospective, case-control study. The study included 41 patients (51 eyes) with primary open-angle glaucoma. Methods The patients were randomly divided into two groups. The experimental group underwent modified trabeculectomy, that is, a vertical scleral flap and trabecular meshwork were excised, while peripheral iridectomy and partial subconjunctival fascia resection were performed. The control group underwent trabeculectomy. The patients were followed up for 1 year. Intraocular pressure, visual acuity, functional filtration bleb retention and complications were observed. The curative effects of the two surgical methods were compared. The main indicators of intraocular pressure, visual acuity, functional filtering bleb and surgical complications. Results The follow-up period was 1 year. The intraocular pressure (IOP) of 97.2% (25/26) in the experimental group was lower than 21 mmHg and that in the control group was 76.0% (19/25). The best corrected visual acuity was no significant difference between the two groups. No serious complications occurred in either group after operation. Conclusion The modified trabeculectomy is more effective than the traditional trabeculectomy for long-term IOP and is a safe and effective surgical method for the treatment of open-angle glaucoma.