结膜瓣下水囊的形成在复合式小梁切除术中的应用

目的:探讨复合式小梁切除术中结膜瓣下水囊的形成对预测和控制术后滤过量及减少并发症的疗效。方法:186例200眼原发性青光眼随机分为观察组与对照组。观察组行结膜瓣下水囊的形成结合复合式小梁切除术(即可拆缝线、丝裂霉素C和小梁切除术),对照组行复合式小梁切除术。同期进行疗效观察对比。指标包括视力、眼压、滤过泡、前房深度及并发症,随访12mo。结果:术后早期,观察组浅前房、滤过泡渗漏及并发症的发生率明显低于对照组,术后远期,观察组眼压明显低于对照组,视力下降及非功能性滤过的发生率也明显低于对照组。结论:结膜瓣下水囊的形成可有效控制眼压,减少术后滤过泡渗漏、浅前房、恶性青光眼等并发症发生。

The effect of water sac under the conjunctival flap formation in the compound trabeculectomy

AIM: To observe the outcome of application of water sac under the conjunctival flap formation combing with adjustable suture in estimating and controlling the post-operational filtering outflow in compound trabeculectomy.

METHODS: Totally 200 eyes of 186 cases of primary glaucoma were randomly divided into observation group and compared group. All eyes of observation group underwent application of water sac under the conjunctival flap formation combining with ajdustable suture and mitomycin-C in compound trabeculectomy. Eyes in control group underwent compound trabeculectomy only. All cases were observed for 12 months, including visual acuity, intraocular pressure(IOP), filtering blebs, depth of anterior chamber, and other complications.

RESULTS: In the early term after operation, the shallow anterior chamber and other complication in observation group was obviously less than that in control group. In the far term after operation, the IOP in observation group was lower than that in control group, visual loss and non functional blebs in observation group was obviously less than that in control group.

CONCLUSION: Water sac under the conjunctival flap formation combining with adjustable suture in compound trabeculectomy is useful for controlling IOP, and less complication(bleb leakage, shallow anterior chamber, malignant glaucoma etc.)