Vuori Marja-Liisa
Department of Ophthalmology, Turku University Hospital, Turku, Finland.
Acta Ophthalmol Scand. 2004 Apr;82(2):154-7. doi: 10.1111/j.1600-0420.2004.00242.x.
To study the appearance of the trabeculo-Descemet's membrane (TDM) after deep sclerectomy with collagen implant (DSCI).
All patients who underwent a successful DSCI for open-angle glaucoma were included in a non-randomized clinical study. Gonioscopy was performed between 6 and 12 months postoperatively in all patients.
Gonioscopy was performed in 42 eyes of 38 patients after a mean follow-up time of 8.3 +/- 2.5 months after DSCI. The diagnosis was chronic open-angle glaucoma in 16 eyes and exfoliative glaucoma in 24 eyes. One patient had pigmentary glaucoma and one had normal tension glaucoma. None of the patients were on glaucoma medication postoperatively. Synechias to the TDM were seen in five eyes. Pigment accumulation to the TDM was seen in nine eyes, four of which had capsular glaucoma, three had primary open-angle glaucoma, one had pigmentary glaucoma and one had normal tension glaucoma. Puncture holes at the TDM were seen in all eight eyes in which Nd:YAG laser goniopuncture had been performed.
Postoperative changes, which may go unnoticed without routine gonioscopy, occur at the TDM after deep sclerectomy with collagen implant. Pigment accumulates relatively shortly after surgery. Whether or not these changes are progressive remains unknown. Careful follow-up after deep sclerectomy is necessary and should include routine gonioscopy.
研究胶原植入物深层巩膜切除术（DSCI）后小梁-Descemet膜（TDM）的表现。
所有因开角型青光眼成功接受DSCI的患者均纳入一项非随机临床研究。所有患者在术后6至12个月进行前房角镜检查。
38例患者的42只眼在DSCI术后平均随访8.3±2.5个月后进行了前房角镜检查。诊断为慢性开角型青光眼16只眼，剥脱性青光眼24只眼。1例患者为色素性青光眼，1例为正常眼压性青光眼。所有患者术后均未使用青光眼药物。5只眼可见与TDM的粘连。9只眼可见TDM有色素沉着，其中4只眼患有晶状体溶解性青光眼，3只眼患有原发性开角型青光眼，1只眼患有色素性青光眼，1只眼患有正常眼压性青光眼。在所有接受Nd:YAG激光前房角穿刺的8只眼中均可见TDM的穿刺孔。
胶原植入物深层巩膜切除术后，TDM会出现术后变化，若无常规前房角镜检查可能未被注意到。色素在术后相对较短时间内积聚。这些变化是否会进展尚不清楚。深层巩膜切除术后需要仔细随访，应包括常规前房角镜检查。
