Galand A
Service d'Ophtalmologie, CHU Sart-Tilman, B-4000 Liège.
Bull Soc Belge Ophtalmol. 2000;Suppl:87-92.
When a trabeculectomy does not reduce the intraocular pressure, it is usually due to sealing of the scleral flap to the adjacent sclera, while the trabeculectomy itself remains open. A triangular excision in the scleral flap seems likely to keep the fistula in function. Deep sclerectomy does not lead to major hypotony, "the other complication" of trabeculectomy. However, the non perforating sclerectomy, under a sutured superficial scleral flap, could in the long term become inefficient. I propose a deep sclerectomy with controlled perforation under a notched superficial flap.
当小梁切除术未能降低眼压时，通常是由于巩膜瓣与相邻巩膜封闭，而小梁切除术本身仍保持开放。巩膜瓣的三角形切除术似乎有可能使瘘管保持功能。深层巩膜切除术不会导致小梁切除术的“另一种并发症”——严重低眼压。然而，在缝合的表层巩膜瓣下进行的非穿透性巩膜切除术，从长远来看可能会失效。我建议在有切口的表层瓣下进行可控穿孔的深层巩膜切除术。
