Jones Emma, Clarke Jonathan, Khaw Peng Tee
ORB (Ocular Repair and Regeneration Biology), Divisions of Pathology and Glaucoma, Institute of Ophthalmology and Moorfields Eye Hospital, London, UK.
Curr Opin Ophthalmol. 2005 Apr;16(2):107-13. doi: 10.1097/01.icu.0000156138.05323.6f.
Trabeculectomy is an effective operation for lowering intraocular pressure. However, success is limited by complications such as infection, hypotony, and scarring.
These complications, which are increased by antifibrotic use, can be reduced with attention to surgical technique. We highlight the benefit of sub-Tenon anaesthesia, careful choice of the surgical site, fashioning of the scleral flap to produce diffuse aqueous flow, and better intraocular pressure control, maintenance of intraocular pressure, a formed anterior chamber, with outflow control during surgery using an infusion, optimal method of antimetabolites application, new adjustable sutures, and corneal-conjunctival closure techniques.
These techniques reduce hypotony, producing a diffuse noncystic bleb with long-term pressure control.
小梁切除术是降低眼压的有效手术。然而，其成功率受到感染、低眼压和瘢痕形成等并发症的限制。
这些因抗纤维化药物使用而增加的并发症，可通过关注手术技术来减少。我们强调了以下几点的益处：球结膜下麻醉、手术部位的谨慎选择、制作巩膜瓣以实现房水的弥散流动、更好的眼压控制、眼压的维持、前房的形成，术中使用灌注液进行流出控制、抗代谢药物应用的最佳方法、新型可调节缝线以及角膜-结膜闭合技术。
这些技术可减少低眼压的发生，形成一个能长期控制眼压的弥散性非囊性滤过泡。
