Van Buskirk E M
Devers Eye Institute, Good Samaritan Hospital and Medical Center, Portland, Oregon.
Am J Ophthalmol. 1992 Feb 15;113(2):145-53. doi: 10.1016/s0002-9394(14)71526-0.
A trabeculectomy technique with conventional instruments, but without conjunctival incision or intracameral manipulation, was completed in 12 eye-bank eyes, two cat eyes, and in five patients with glaucoma. A partial-thickness limbal corneal flap provided access to an intrastromal limbal pocket through which the subconjunctival space was entered with an irrigating cystotome. The anterior chamber was entered at the surgical corneoscleral limbus beneath the corneal flap and the peripheral iridectomy was completed without difficulty. Full-thickness or guarded limbal fistulas could be created. Guarded limbal fistulas were completed in five of five patients with glaucoma. The technique produced low-lying, diffuse filtration blebs that persisted throughout the three-month postoperative period and reduced mean intraocular pressure from 33 to 12 mm Hg. Corneal trabeculectomy holds promise as a method for a filtration operation that does not require conjunctival incision, intracameral manipulation, or costly technology.
采用传统器械完成了小梁切除术，该手术不做结膜切口或前房内操作，共对12只眼库眼、2只猫眼以及5例青光眼患者实施了手术。制作一个角膜缘部分厚度的角膜瓣，由此进入基质内角膜缘袋，通过一个灌注式膀胱刀经此进入结膜下间隙。在角膜瓣下方的手术性角巩膜缘处进入前房，顺利完成周边虹膜切除术。可形成全层或带蒂角膜缘瘘。5例青光眼患者均成功制作了带蒂角膜缘瘘。该技术产生的滤过泡低平、弥散，在术后3个月内持续存在，平均眼压从33毫米汞柱降至12毫米汞柱。角膜小梁切除术有望成为一种无需结膜切口、前房内操作或昂贵技术的滤过手术方法。
