论文部分内容阅读
近年来,房水引流性植入物已成为治疗顽固性青光眼的一种辅助手段。Molteno植入物是最广泛应用的装置之一。该装置能提供由前房引流房水到后部结膜下间隙(蓄积池)的永久性通道。最近对Molteno植入物的设计和手术方法的改进使其成功率上升,并发症如低眼压,无前房及植入管与角膜内皮接触等的发生率下降。此改进包括前房内注入透明质酸钠;用针做通道,然后将引流管从通道插入前房。手术分二期进行,用双盘植入物,暂时性结扎引流管,用供者巩膜片并辅以抗纤维治疗。本文描述Molteno植入物的应用原理、适应证、手术方法、结果及并发症。
In recent years, aqueous drainage implants have become an adjunct to refractory glaucoma. Molteno implants are one of the most widely used devices. The device provides a permanent passage of aqueous humor from the anterior chamber to the posterior subconjunctival space (reservoir). Recent improvements in the design and surgical approach to Molteno implants have led to an increased rate of success with a reduction in the incidence of complications such as hypotension, anterior chamber and exposure of the implant to the corneal endothelium. The improvements include the injection of sodium hyaluronate into the anterior chamber; the needles to be made into channels, and the drainage tubes to be inserted into the anterior chamber from the channels. Surgery in two phases, with double disc implants, temporary drainage tube, with donor scleral films and supplemented with anti-fiber therapy. This article describes the application of Molteno implants, indications, surgical methods, results and complications.