Marrakchi S, Nacef L, Kamoun N, Jeddi A, Ayed S
Institut Hedi Rais d'Ophtalmologie de Tunis, Tunisie.
J Fr Ophtalmol. 1992;15(6-7):400-4.
Congenital glaucoma has a very serious prognosis. It represents the first cause of blindness in Tunisian children. Trabeculectomy introduced by Cairns in 1968, was initially proposed as second-line treatment in congenital glaucoma surgery. It has now become more frequently used as first-line treatment in this indication. We have already used this technique directly in 35 children suffering from congenital glaucoma with a total of 54 eyes. Forty four eyes underwent a single operation, ten eyes underwent two to four trabeculectomies. Then study of these cases with a mean follow up of 24 months shows an overall success rate of 64% after one trabeculectomy, with or without additional medical treatment. The study of tonometric diagrams shows that the successful results obtained after 3 months persisted in the long term. Trabeculectomy gives better results in congenital glaucoma with intraocular pressure greater than 40 mmHg. Repeated operations are sometimes necessary. In these cases, postoperative subconjunctival 5 fluorouracil (SFU) did not improve the surgical outcome.
先天性青光眼的预后非常严重。它是突尼斯儿童失明的首要原因。1968年凯恩斯引入的小梁切除术，最初被提议作为先天性青光眼手术的二线治疗方法。如今，它在这种适应症中越来越多地被用作一线治疗方法。我们已经直接对35名患有先天性青光眼的儿童（共54只眼睛）使用了这种技术。44只眼睛接受了单次手术，10只眼睛接受了两到四次小梁切除术。对这些病例进行平均24个月的随访研究表明，无论是否进行额外的药物治疗，一次小梁切除术后的总体成功率为64%。眼压图研究表明，3个月后获得的成功结果长期持续。小梁切除术在眼压高于40 mmHg的先天性青光眼中效果更好。有时需要重复手术。在这些情况下，术后结膜下注射5-氟尿嘧啶（SFU）并不能改善手术效果。
