Lai J S, Lam D S
Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Shatin, Hong Kong.
J Glaucoma. 1999 Jun;8(3):188-92.
This study was conducted to evaluate prospectively the surgical outcome in terms of intraocular pressure (IOP) control and safety of trabeculectomy using a sutureless scleral tunnel technique in patients with uncomplicated primary open-angle glaucoma (POAG).
Patients with POAG whose IOP was more than 21 mmHg with administration of maximally tolerated medications were recruited for this study. All patients underwent the sutureless scleral tunnel trabeculectomy under retrobulbar anesthesia. Intraoperative complications and postoperative visual acuity, IOP, bleb status, and complications were evaluated for a follow-up period of 1 year.
Surgery was performed in 18 patients (20 eyes); 17 of the patients (19 eyes) completed the study (one patient was excluded because of defaulted follow-up). Mean IOP was 26.6 +/- 3.6 mmHg before surgery and 15.3 +/- 3.0 mmHg 1 year after surgery. No intraoperative complications were encountered. Mild hyphema (10.5%) and shallow anterior chamber (15.8%) were noted in the immediate postoperative period, but both were managed successfully with conservative treatment. The absolute success rate was 79.0%.
The preliminary results of this study are encouraging. It appears that sutureless scleral tunnel trabeculectomy is a safe and effective drainage procedure for treating uncomplicated POAG. A larger-scale study with a longer follow-up period seems warranted.
本研究旨在前瞻性评估采用无缝线巩膜隧道技术行小梁切除术治疗单纯原发性开角型青光眼（POAG）患者的眼压（IOP）控制情况及手术安全性。
招募使用最大耐受剂量药物治疗后眼压仍高于21 mmHg的POAG患者进行本研究。所有患者均在球后麻醉下行无缝线巩膜隧道小梁切除术。对患者进行为期1年的随访，评估术中并发症及术后视力、眼压、滤过泡状态和并发症情况。
18例患者（20只眼）接受手术；17例患者（19只眼）完成研究（1例患者因失访被排除）。术前平均眼压为26.6±3.6 mmHg，术后1年为15.3±3.0 mmHg。术中未出现并发症。术后早期出现轻度前房积血（10.5%）和浅前房（15.8%），但均经保守治疗成功处理。绝对成功率为79.0%。
本研究的初步结果令人鼓舞。无缝线巩膜隧道小梁切除术似乎是治疗单纯POAG的一种安全有效的引流手术。有必要进行更大规模、更长随访期的研究。
