Zohdy G A, Lukaris A, Rogers Z A, Hill A, Roberts-Harry T J
Ophthalmic Department, West Wales General Hospital, Carmarthen, UK.
Int Ophthalmol. 1998;22(4):253-6. doi: 10.1023/a:1006345032639.
To evaluate the effectiveness of punch trabeculectomy in controlling intraocular pressure (IOP) in patients with uncontrolled chronic open-angle glaucoma (COAG) undergoing medical treatment.
This prospective study included 22 patients (27 eyes) with uncontrolled COAC on medical treatment undergoing punch trabeculectomy through a scleral tunnel. The tunnel was created with a 3.5 mm keratome, the tunnel mouth was not sutured but the conjunctival flap was sutured by 8/0 vicryl. The mean surgical time from opening the conjunctiva to closing the conjunctiva was 8 m 59 s. IOP and other parameters were checked on day 1 and subsequently at intervals appropriate to the individual.
After a mean period of 22.2 months follow-up the mean IOP was 13.3 mmHg (SD 5.2). There were few transient early post-operative complications; two eyes had a shallow anterior chamber (AC) due to excess drainage, five had IOP above 21 mmHg, which responded to ocular massage, ten eyes had hyphaema less than 1.5 mm and two eyes had no filtration bleb.
Punch trabeculectomy is a rapid and effective method of controlling IOP. The complication rate is moderate and mainly transient.
评估冲压小梁切除术对接受药物治疗但眼压控制不佳的慢性开角型青光眼（COAG）患者控制眼压（IOP）的有效性。
这项前瞻性研究纳入了22例（27只眼）接受药物治疗但眼压控制不佳的COAC患者，通过巩膜隧道进行冲压小梁切除术。隧道用3.5毫米角膜刀制作，隧道口不缝合，但结膜瓣用8/0可吸收缝线缝合。从打开结膜到关闭结膜的平均手术时间为8分59秒。在术后第1天检查眼压及其他参数，随后根据个体情况定期检查。
平均随访22.2个月后，平均眼压为13.3 mmHg（标准差5.2）。术后早期短暂并发症较少；2只眼因引流过多出现浅前房（AC），5只眼眼压高于21 mmHg，经眼部按摩后恢复正常，10只眼有小于1.5毫米的前房积血，2只眼没有滤过泡。
冲压小梁切除术是一种快速有效的控制眼压的方法。并发症发生率中等，且主要为短暂性。
