Pojda S M, Herba E, Zatorska B, Pojda-Wilczek D, Rycerska A, Plech A, Jedrzejewski W
Katedry i Oddziału Klinicznego Okulistyki Slaskiej AM w Katowicach, Szpital Specjalistyczny Nr 1 w Bytomiu.
Klin Oczna. 2001;103(4-6):161-4.
To estimate the efficacy of trabeculectomy for primary open angle glaucoma.
Since 1990 to 2000 we observed 91 eyes of 79 patients (53 women and 26 men) aged 39-86. The results of performed surgery were valued directly after the trabeculectomy and in period of over 8 years. We carried out the examinations of visual acuity, intraocular pressure, visual field, state of optic nerve head, type of bleb following trabeculectomy and the necessity of applying additional topical treatment. The trabeculectomies were performed in a typical way. Some surgeons made a square or triangular superficial scleral flap based at the limbus, measuring from 2.5 x 3.0 to 4 x 4 mm or 3 x 3 mm. The deep block of scleral tissue with trabeculum (from 0.5 x 1.0 to 2.5 x 3.0 mm) was excised, the superficial cauterisation and the peripheral iridectomy were performed in every case. The scleral flap and conjunctiva were sutured with 10/0 Ethilon, 8/0 Vicryl or 6/0 Mersilk.
The patients were divided into 3 groups depending on observation period: I--up to 4 years, II--from 5 to 8 years, III--over 8 years. We confirmed the normalisation of IOP in 80%, 73%, 90% and the successful control of visual field (no progress) in 82%, 77%, 70% of adequate groups. In the first and second group 45-50% of patients could resist from topical treatment, but after 8 years as many as 80% required additional pharmacological treatment.
The trabeculectomy is the effective surgery in most patients with open angle glaucoma. The effectiveness of trabeculectomy can be controlled by the size of extracted deep scleral flap with trabeculum. For the stability of visual field it is necessary to keep the intraocular pressure at 13-18 mm Hg level.
评估小梁切除术治疗原发性开角型青光眼的疗效。
1990年至2000年，我们观察了79例患者（53例女性和26例男性）的91只眼睛，年龄在39 - 86岁之间。在小梁切除术后及超过8年的时间段内直接评估手术效果。我们进行了视力、眼压、视野、视神经乳头状态、小梁切除术后滤过泡类型以及应用额外局部治疗必要性的检查。小梁切除术采用典型方式进行。一些外科医生制作以角膜缘为基底的方形或三角形浅层巩膜瓣，尺寸为2.5×3.0至4×4毫米或3×3毫米。切除带有小梁的深层巩膜组织块（0.5×1.0至2.5×3.0毫米），每例均进行浅层烧灼和周边虹膜切除术。巩膜瓣和结膜用10/0 Ethilon、8/0 Vicryl或6/0 Mersilk缝合。
根据观察期将患者分为3组：I组——至4年，II组——5至8年，III组——超过8年。我们证实I组、II组、III组的眼压正常化率分别为80%、73%、90%，视野成功控制（无进展）率分别为82%、77%、70%。在第一组和第二组中，45 - 50%的患者可停用局部治疗，但8年后多达80%的患者需要额外的药物治疗。
小梁切除术对大多数开角型青光眼患者是有效的手术。小梁切除术的有效性可通过切除的带小梁深层巩膜瓣的大小来控制。为保持视野稳定，眼压需维持在13 - 18毫米汞柱水平。
