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目的探讨最常用的青光眼滤过手术小梁切除术中可调节缝线的应用对术后早期浅前房的控制作用。方法在小梁切除术中根据病情使用不同时间的0.4﹪的丝裂霉素,切除1×2mm小梁,行虹膜根部切除,将巩膜瓣两个角处固定缝合两针,于瓣一侧缝可调节线一针,为活结,可拉开一端留线较长,从角膜缘结膜切口引出,以便随时拆除,术后主要观察一周内眼压及前房情况。结果 209眼术后一周内眼压均在12-21mmHg,于一周后拆除结膜缝线时将调节线外露端剪除。26眼眼压在22-26mmHg,15眼于术后第二天拆除可调节缝线,7眼于术后第三天拆除可调节缝线,4眼于术后第五天拆除可调节缝线,均配合按摩,眼压于拆除可调节缝线后降至14-20mmHg,无一例非计划二次手术,无1例感染发生。结论小梁切除术中应用可调节缝线,其操作简单,在手术同时完成,解决了术后早期浅前房的发生,若眼压控制不理想可随时拆除可调节缝线并按摩,增加滤过,得到理想的眼压,是简单,易学,可行的手术方法。
Objective To investigate the effect of adjustable sutures in the most commonly used glaucoma filtration trabeculectomy on the control of early postoperative shallow anterior chamber. Methods In trabeculectomy, 0.4% mitomycin was used according to the condition, 1 × 2mm trabeculae were excised and the iris roots were excised. The two stitches of the scleral flap were fixed with two stitches, A needle can be adjusted, to live knot, can pull open a longer stay, from the limbal conjunctival incision lead to be removed at any time, postoperative main observation intraocular pressure and anterior chamber conditions. Results 209 eyes were intraocular pressure within 12-21mmHg one week after surgery, the exposed end of the adjustment line was cut off when the conjunctival suture was removed one week later. Twenty-six eyes underwent intraocular pressure at 22-26 mmHg. Fifteen eyes received adjustable sutures on the second postoperative day, seven on the third day postoperatively, four on the fifth postoperative day , Both with massage, intraocular pressure after the removal of adjustable suture dropped to 14-20mmHg, no case of non-planned secondary surgery, no case of infection occurred. Conclusions The application of adjustable sutures in trabeculectomy is simple and easy to operate. It can be performed simultaneously with surgery to solve the problem of early shallow anterior chamber after operation. If the intraocular pressure is not controlled well, the adjustable sutures can be removed at any time and massaged Over, get the ideal intraocular pressure, is simple, easy to learn, feasible surgical methods.