尼日利亚一家教学医院小梁切除术的回顾。
A review of trabeculectomies at a nigerian teaching hospital.
作者信息
Adegbehingbe Bo, Majemgbasan T
机构信息
Ophthalmology Unit, Department of Surgery, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
出版信息
Ghana Med J. 2007 Dec;41(4):176-80. doi: 10.4314/gmj.v41i4.55287.
SUMMARY BACKGROUND
Trabeculectomy is the commonest surgical procedure for glaucoma. The outcome of trabeculectomy in the treatment of all types of glaucoma over a 4-year period in a Nigerian population was reviewed.
OBJECTIVE
To determine the surgical rate and effectiveness of trabeculectomy in lowering of intra ocular pressure (IOP) and preservation of visual acuity.
METHODS
Retrospective review of all trabeculectomies (TEs) done at the Obafemi Awolowo University Teaching Hospital, Ile-Ife between January 1999 and December 2002. The outcome of trabeculectomy was correlated with the biomicroscopic appearance of the filtering bleb, visual acuity and IOP levels. Descriptive statistics were applied to the data.
RESULTS
Of the 647 glaucoma patients only fifty-three (8.2%), 34 males and 19 females, had trabeculectomy done during the study period. Seventy-two consecutive eyes of these 53 Nigerian patients were operated upon. Majority, 63 (87.5%) were in the primary glaucoma group of which 46 (63.9%) were open angle glaucoma type. Nine eyes (12.5%) belonged to the secondary glaucoma group (neovascular, uveitic and traumatic angle recession). Successful control of intra-ocular pressure with medical therapy was recorded only in 13.9% of the patients. The mean pre-operative and first post-operative day IOP were 32.5+/- 6.2mmHg and 10.6+/- 2.3mmHg respectively. Mean post-op IOP at 3 months and one year were 14.6+/- 4.2mmHg, and 13.5+/- 5.8mmHg respectively. One year after surgery 34 eyes (61.8%) had intraocular pressure (IOP) of 20mm Hg or less without glaucoma medication. Hyphema 11 (15.3%) was the commonest post-operative complication documented.
CONCLUSIONS
Surgical intervention in the management of glaucoma, especially trabeculectomy is not commonly done in this Teaching Hospital. IOP control with medication alone is not adequate in the long term. A significant proportion of the eyes (61.8%) had complete success in IOP control following trabeculectomy.
摘要 背景：小梁切除术是青光眼最常见的外科手术。回顾了在尼日利亚人群中，小梁切除术在4年期间治疗所有类型青光眼的结果。
目的
确定小梁切除术在降低眼压（IOP）和保留视力方面的手术率及有效性。
方法
回顾性分析1999年1月至2002年12月在伊费奥巴费米·阿沃洛沃大学教学医院进行的所有小梁切除术（TEs）。将小梁切除术的结果与滤过泡的生物显微镜外观、视力和眼压水平相关联。对数据应用描述性统计。
结果
在647例青光眼患者中，只有53例（8.2%），男性34例，女性19例，在研究期间接受了小梁切除术。这53例尼日利亚患者的72只眼睛连续接受了手术。其中大多数，63例（87.5%）属于原发性青光眼组，其中46例（63.9%）为开角型青光眼。9只眼睛（12.5%）属于继发性青光眼组（新生血管性、葡萄膜炎性和外伤性房角后退）。仅13.9%的患者记录到药物治疗成功控制眼压。术前和术后第一天的平均眼压分别为32.5±6.2mmHg和10.6±2.3mmHg。术后3个月和1年的平均眼压分别为14.6±4.2mmHg和13.5±5.8mmHg。手术后1年，34只眼睛（61.8%）在未使用青光眼药物的情况下眼压（IOP）为20mmHg或更低。前房积血11例（15.3%）是记录到的最常见术后并发症。
结论
在这家教学医院，青光眼的手术干预，尤其是小梁切除术并不常见。仅用药物控制眼压长期来看并不充分。相当比例的眼睛（61.8%）在小梁切除术后眼压控制取得了完全成功。
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