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[小梁切除术后青少年青光眼的预后]

[Prognosis in juvenile glaucoma after trabeculectomy].

作者信息

Koraszewska-Matuszewska Bronisława, Samochowiec-Donocik Elzbieta, Filipek Erita

机构信息

Katedry i Kliniki Okulistyki Dzieciecej Slaskiej Akademii Medycznej, Katowicach.

出版信息

Klin Oczna. 2002;104(2):115-8.

Abstract

PURPOSE

To evaluate the efficacy of trabeculectomy in the patients with juvenile glaucoma in the long-term follow-up.

MATERIAL AND METHODS

In 22 of 37 patients--41 trabeculectomies with basal iridectomy were performed. The age of children ranged from 6 to 18 years, mean 12.4 years. In one eye of 15-year-old boy we used Mitomycin C during reoperation. The follow-up period ranged from 2 to 14 years, mean 8 years. Patients were divided into 2 groups depending on the follow-up: I group (19 eyes) was observed 2-6 years, mean 5.1 years, II group (18 eyes) 7-14 years, mean 11.1 years. In the I group 57.9% and in the II group 61% of children were myopic.

RESULTS

Intraocular pressure lower or equal to 21 mmHg with no glaucoma medication was obtained in 79% of eyes in the I group and 66.7% of eyes in the II group. The difference was not statistically significant. In other eye local application of B-blockers and dorzolamid decreased intraocular pressure to values safe for the optic nerve, what was monitored by visual acuity and laser scanning tomography.

CONCLUSION

Prognosis of juvenile glaucoma patients treated with trabeculectomy is satisfactory but the effectiveness of this procedure decreases together with the elongation of the follow-up period.

摘要

目的

通过长期随访评估小梁切除术治疗青少年青光眼患者的疗效。

材料与方法

37例患者中的22例——实施了41次小梁切除术并联合周边虹膜切除术。患儿年龄6至18岁,平均12.4岁。在一名15岁男孩的一只眼中,再次手术时使用了丝裂霉素C。随访时间为2至14年,平均8年。根据随访情况将患者分为2组:I组(19只眼)观察2至6年,平均5.1年,II组(18只眼)观察7至14年,平均11.1年。I组中57.9%的儿童和II组中61%的儿童为近视。

结果

I组79%的患眼和II组66.7%的患眼在未使用青光眼药物的情况下眼压降至21 mmHg或更低。差异无统计学意义。在另一只眼中,局部应用β受体阻滞剂和多佐胺可将眼压降至对视神经安全的值,通过视力和激光扫描断层扫描进行监测。

结论

小梁切除术治疗青少年青光眼患者的预后良好,但该手术的有效性会随着随访时间的延长而降低。

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