Alekseev B N, Ermolaev A P
Vestn Oftalmol. 2003 Jul-Aug;119(4):7-10.
We made a total of 96 surgeries of extracapsular cataract extraction and IOL implantation combined with trabeculotomy ab interno during a period of 7 years. Patients with both open-angle and narrow-angle glaucoma of stages I and II and with the intraocular pressure (IOP) below or equal to 23 mm Hg according to Goldman under the conditions of hypotensive medicamental regimen were selected for surgery. After IOL was implanted into the lens bag, trabeculotomy ab interno was implemented as stage 2. A special mirror, introduced through the cataract incision, was used for direct gonioscopic monitoring. The trabecula was incised by the edge of a curved surgical knife under direct visual control. We regarded bleeding from the opened sinus as a favorable sign indicative of that the intrascleral collectors were intact. Only minor hyphemas were registered as postoperative complications; there was not a single case of ciliary-and-choroidal detachment. IOP was compensated for, in 6 months after surgery, in 94% of patients--69.8% of them did not use any hypotensive drops.
在7年的时间里，我们总共进行了96例白内障囊外摘除联合人工晶状体植入术并联合内路小梁切开术。选择在降压药物治疗方案下，眼压（IOP）根据戈德曼眼压计测量低于或等于23 mmHg的原发性开角型青光眼和原发性闭角型青光眼I、II期患者进行手术。人工晶状体植入晶状体囊袋后，二期进行内路小梁切开术。通过白内障切口插入一个特殊的镜子，用于直接前房角镜监测。在直接视觉控制下，用弯形手术刀的边缘切开小梁。我们认为开放的窦道出血是巩膜内集合管完整的有利迹象。术后并发症仅记录到少量前房积血；没有一例睫状体和脉络膜脱离。术后6个月，94%的患者眼压得到控制，其中69.8%的患者无需使用任何降压滴眼液。
