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目的研究小梁切除术中同时施行周边虹膜切除术的作用。方法回顾性分析75例(75眼)施行小梁切除术的患者的临床资料,术中伴随或不伴随施行周边虹膜切除术。所有患者均随访1a以上。收集患者术前,术后1d、30～90d、1～3a的一般资料,包括视力、眼压、滤过泡情况、术后感染及并发症情况。其中,36眼(48%)施行小梁切除术的同时施行白内障摘出术;43眼(57%)术中常规施行周边虹膜切除术。以t检验进行统计学分析。结果术后30～90d,患者术中同时施行周边虹膜切除术者比未施行者有更高的感染率(术中合并行白内障摘出术者P=0.018,没有行白内障摘出术者P=0.038)。术中施行或未施行虹膜切除术者,眼压比较差异无统计学意义。术后并发症在2组中均很少,但施行周边虹膜切除术者,其发生并发症的眼数相对较多。结论小梁切除术中不施行周边虹膜切除术有与施行周边虹膜切除术一样的降眼压效果。但它更安全,有更低的术后感染机会,还可以避免因施行周边虹膜切除术而诱发的术后浅前房或瞳孔阻滞的发生。
Objective To study the effect of perioperative iridotomy in trabeculectomy. Methods The clinical data of 75 patients (75 eyes) underwent trabeculectomy were retrospectively analyzed. Perioperative iridotomy was performed with or without operation. All patients were followed for more than 1a. Preoperative, postoperative 1d, 30 ~ 90d, 1 ~ 3a general information, including visual acuity, intraocular pressure, filtration bleb, postoperative infection and complications were collected. Among them, 36 eyes (48%) underwent trabeculectomy combined with cataract extraction; 43 (57%) patients underwent routine iridectomy. T test for statistical analysis. Results Patients with peripheral iridotomy at the same time had a higher infection rate (P = 0.018 in patients with cataract surgery and P = 0.038 in patients without cataract surgery) than those without surgery at 30 ~ 90 days after operation. . Intraoperative implementation or without iridectomy, intraocular pressure was no significant difference. Postoperative complications in the two groups were very few, but the implementation of peripheral iridectomy, the occurrence of complications of the eye relatively large number. Conclusions Perioperative iridectomy without trabeculectomy has the same hypotensive effect as peripheral iridotomy. However, it is safer and has a lower chance of postoperative infection. It also avoids postoperative shallow anterior chamber or pupillary block induced by peripheral iridotomy.