Tamcelik N, Ozkiris A
Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
Br J Ophthalmol. 2008 Jan;92(1):36-9. doi: 10.1136/bjo.2007.114389.
To evaluate the outcomes of viscotrabeculotomy in patients with primary congenital glaucoma and to compare the success and complications rates with classical trabeculotomy.
Patients who were selected for this study had all presented with primary congenital glaucoma before the age of 12 months, and they were divided into two groups. Group 1 consisted of 58 eyes of 34 patients who underwent viscotrabeculotomy, and group 2 consisted of 51 eyes of 30 patients who underwent classical trabeculotomy. Pre-and postoperative intraocular pressures (IOPs), mean antiglaucoma medication, mean corneal diameter, success rates, intra-and postoperative complications were compared between two groups.
Mean preoperative IOP was 30.6 (SD 5.7) mm Hg in group 1 and 29.9 (4.9) mm Hg in group 2. At the last visits, it was 16.2 (2.9) mm Hg and 17.3 (2.8) mm Hg, respectively (p<0.001). The mean number of antiglaucoma medications used after surgery was significantly lower in group 1 (p<0.05). At the last visits, the success rates of group 1 and group 2 were 91.3% and 68.6%, respectively, and the difference was statistically significant (p = 0.02). The most common early postoperative complication was transient IOP elevation in group 1 and hyphaema in group 2 (for each, p<0.001).
Use of viscoelastic materials during trabeculotomy may increase the success rate of the procedure by prevention of postoperative haemorrhage, adhesion of the incision lips or fibroblastic proliferation.
评估原发性先天性青光眼患者行粘弹剂小梁切开术的效果,并与传统小梁切开术的成功率和并发症发生率进行比较。
本研究入选的患者均在12个月龄之前被诊断为原发性先天性青光眼,将他们分为两组。第1组由34例患者的58只眼组成,接受了粘弹剂小梁切开术;第2组由30例患者的51只眼组成,接受了传统小梁切开术。比较两组患者术前和术后的眼压(IOP)、平均抗青光眼药物使用情况、平均角膜直径、成功率、术中及术后并发症。
第1组术前平均眼压为30.6(标准差5.7)mmHg,第2组为29.9(4.9)mmHg。在最后一次随访时,分别为16.2(2.9)mmHg和17.3(2.8)mmHg(p<0.001)。第1组术后使用抗青光眼药物的平均数量显著更低(p<0.05)。在最后一次随访时,第1组和第2组的成功率分别为91.3%和68.6%,差异有统计学意义(p = 0.02)。术后最常见的早期并发症,第1组是短暂性眼压升高,第2组是前房积血(每组均为p<0.001)。
小梁切开术中使用粘弹性材料可能通过预防术后出血、切口唇粘连或成纤维细胞增殖而提高手术成功率。