Galin M A, Boniuk V, Robbins R M
Am J Ophthalmol. 1975 Oct;80(4):696-701. doi: 10.1016/0002-9394(75)90402-x.
Clinical and histologic studies in 40 eyes of 35 patients with chronic open-angle glaucoma or chronic angle-closure glaucoma operated by various types of "trabeculectomies" were assessed to evaluate whether success was correlated with the surgical approach or with the presence of trabecular tissue in the pathologic specimen. It was clearly demonstrated that it is not necessary to localize or enter Schlemm's canal in order to perform successful trabeculectomies; it is not necessary to operate posterior to the scleral spur; and it is not necessary to excise either Schlemm's canal or trabecular tissue to achieve success. In essence, trabeculectomies primarily function as fistulizing operations carried out under scleral flaps substituting a scleral-conjunctival barrier to aqueous flow rather than the conjunctival barrier alone provided by standard glaucoma operations. This greater obstruction explains the absence of shallow chambers, the reduced incidence of polycystic bleb formation and, perhaps, an avoidance of long-term complications that often result from these two factors.
对35例慢性开角型青光眼或慢性闭角型青光眼患者的40只眼睛进行了临床和组织学研究，这些眼睛接受了各种类型的“小梁切除术”，以评估手术成功是否与手术方式或病理标本中是否存在小梁组织相关。结果清楚地表明，为了成功进行小梁切除术，没有必要定位或进入施莱姆管；没有必要在巩膜突后方进行手术；也没有必要切除施莱姆管或小梁组织来取得成功。从本质上讲，小梁切除术主要起到在巩膜瓣下形成瘘管的作用，替代了阻止房水流动的巩膜-结膜屏障，而不仅仅是标准青光眼手术所提供的结膜屏障。这种更大的阻碍解释了浅前房的缺失、多囊性滤过泡形成发生率的降低，也许还避免了通常由这两个因素导致的长期并发症。
