Lüke Christoph, Dietlein Thomas S, Jacobi Philipp C, Konen Walter, Krieglstein Günter K
Center for Ophthalmology, University of Koln, Koln, Germany.
J Glaucoma. 2002 Aug;11(4):294-9. doi: 10.1097/00061198-200208000-00004.
To assess the intraocular pressure-lowering efficacy and the postoperative complication profile of viscocanalostomy versus trabeculectomy.
Sixty eyes of 60 patients with medically uncontrolled open-angle glaucoma were randomized either to the viscocanalostomy or to the trabeculectomy group of the trial. Viscocanalostomy was performed according to Stegmann's technique using high-molecular-weight sodium hyaluronate to fill the ostia of the Schlemm canal. For trabeculectomy, a modified Cairns-trabeculectomy was performed. Examinations were performed before surgery and postoperatively daily for 1 week. Follow-up visits were scheduled 1, 6, and 12 months after surgery.
The mean (SD) preoperative intraocular pressure was 27.1 (7.1) mm Hg for all patients enrolled. One day after surgery, mean (SD) intraocular pressure was 15.9 (5.2) for the trabeculectomy group (P <0.001) and 15.7 (3.6) for the viscocanalostomy group (P <0.001), respectively. The success rate, defined as an intraocular pressure lower than 22 mm Hg without medication, was 56.7% in the trabeculectomy group and 30% in the viscocanalostomy group at 12 months postoperatively (P = 0.041). The number of postoperative complications was lower in the viscocanalostomy group than in the trabeculectomy group.
In eyes with open-angle glaucoma, viscocanalostomy is less effective in reducing intraocular pressure than standard filtering surgery. However, postoperative complications are more frequent after filtering surgery.
评估粘小管切开术与小梁切除术降低眼压的疗效及术后并发症情况。
60例药物治疗无法控制的开角型青光眼患者的60只眼被随机分为粘小管切开术组或小梁切除术组。粘小管切开术按照施特格曼技术进行，使用高分子量透明质酸钠填充施莱姆管开口。小梁切除术采用改良的凯恩斯小梁切除术。术前及术后每天检查1周。术后1、6和12个月安排随访。
所有入组患者术前平均（标准差）眼压为27.1（7.1）mmHg。术后1天，小梁切除术组平均（标准差）眼压为15.9（5.2）mmHg（P<0.001），粘小管切开术组为15.7（3.6）mmHg（P<0.001）。术后12个月时，定义为无需药物治疗眼压低于22mmHg的成功率，小梁切除术组为56.7%，粘小管切开术组为30%（P=0.041）。粘小管切开术组术后并发症数量低于小梁切除术组。
在开角型青光眼患者中，粘小管切开术降低眼压的效果不如标准滤过手术。然而，滤过手术后术后并发症更常见。
