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目的 :探讨非穿透小梁手术中发生穿透前房的原因及处理。方法 :分析开展的非穿透小梁手术 6 9只眼中 ,发生术中穿透前房的 13例 (14只眼 )的情况及其处理 ,对这 13例患者进行 3～ 12个月的随访 ,行眼压、视力、裂隙灯、眼底镜等检查。结果 :非穿透小梁手术中穿透前房的情况有 :制作深层巩膜瓣时切透或剪穿角巩膜、提巩膜瓣时小梁 后弹力膜裂开、撕开Schlemm管内壁等。微小穿透不处理或行周边虹膜切除 ,穿透范围大 ,改行小梁切除术。平均眼压 ,术前 (2 9 0 4± 8 4 1)mmHg(1mmHg =0 133kPa) ,术后一天 (6 13± 2 92 )mmHg ,经 3～ 12个月随访 ,最后随访眼压 (12 19± 3 2 1)mmHg ,手术前后差异有非常显著性 (t=7 0 0 ,P <0 0 0 1)。结论 :非穿透小梁手术中穿透前房与手术技巧不熟练和手术区解剖不熟悉有关 ,经针对性处理 ,仍可获得良好的效果
Objective: To investigate the causes and management of non-penetrating trabecular penetrating anterior chamber. METHODS: Of the 69 non-penetrating trabecular surgery performed, 13 cases (14 eyes) penetrating the anterior chamber occurred and their management was performed. The 13 patients were followed up for 3 to 12 months , IOP, visual acuity, slit lamp, ophthalmoscopy and other tests. Results: The non-penetrating trabecular meshwork through the anterior chamber were: penetrating or scleral corneal scleral during the deep scleral flap, splitting the posterior trabecular membrane and lifting the Schlemm’s inner wall. Tiny penetrating does not handle or peripheral iridectomy, penetrating a large range, diverted trabeculectomy. The mean intraocular pressure (IOP) was 294 ± 841 mmHg preoperatively (1 mmHg = 0,133 kPa) and one day postoperatively (6,13 ± 2,92 mmHg) 19 ± 3 2 1) mmHg, there was significant difference before and after operation (t = 700, P <0.01). CONCLUSIONS: Non-penetrating trabecular surgery penetrating the anterior chamber is associated with unfamiliar surgical techniques and unfamiliar anatomy of the surgical area. Targeted treatment can still achieve good results