Maldonado-Bas A, Maldonado-Junyent A
Clínica de Ojos Maldonado-Bas Privada SRL, Córdoba, Argentina.
J Cataract Refract Surg. 2001 Sep;27(9):1402-9. doi: 10.1016/s0886-3350(01)00921-x.
To evaluate the results of excimer laser trabecular ablation in the treatment of open-angle glaucoma.
Clínica de Ojos Maldonado Bas Privada, Córdoba, Argentina.
This study comprised 32 eyes that had surgery for open-angle glaucoma between May 1997 and May 2000. The surgical procedure included topical anesthesia, a conjunctival incision, a lamellar scleral flap, and ablation of Schlemm's canal and the trabeculum with a scanning or diaphragm excimer laser system until a microperforation was produced in the underlying corneotrabecular tissue. The microperforation had no effect on the treatment and was used only as a sign that the ablation was deep enough and should be stopped. Schlemm's canal was unroofed, and its inner wall and the trabeculum were partially ablated. The scleral flap and conjunctiva were sutured. No antimetabolites were used.
The mean intraocular pressure was 28.06 mm Hg +/- 9.82 (SD) preoperatively and 13.09 +/- 2.67 mm Hg postoperatively. Complications included hyphema (n = 3), choroidal detachment (n = 5), posterior synechias (n = 1), and posterior synechias and cataract (n = 1).
Excimer laser ablation appears to be an effective option for the treatment of glaucoma that may be easier to perform than other procedures for many surgeons.
评估准分子激光小梁切除术治疗开角型青光眼的效果。
阿根廷科尔多瓦省马尔多纳多·巴斯私人眼科诊所。
本研究纳入了1997年5月至2000年5月间接受开角型青光眼手术的32只眼睛。手术过程包括表面麻醉、结膜切口、板层巩膜瓣，以及使用扫描或光阑准分子激光系统对施莱姆管和小梁进行消融，直至在下方的角膜小梁组织中形成微穿孔。微穿孔对治疗无影响，仅作为消融深度足够应停止的标志。施莱姆管被掀开，其内壁和小梁被部分消融。巩膜瓣和结膜缝合。未使用抗代谢药物。
术前平均眼压为28.06 mmHg±9.82（标准差），术后为13.09±2.67 mmHg。并发症包括前房积血（n = 3）、脉络膜脱离（n = 5）、虹膜后粘连（n = 1）以及虹膜后粘连和白内障（n = 1）。
准分子激光消融术似乎是治疗青光眼的一种有效选择，对许多外科医生来说，它可能比其他手术更容易实施。
