Gale J, Wells A P
Ophthalmology Department, Capital & Coast District Health Board, Wellington, New Zealand.
Br J Ophthalmol. 2008 Sep;92(9):1232-5. doi: 10.1136/bjo.2008.140129. Epub 2008 Jul 10.
To assess the safety and success of Safe Surgery System trabeculectomy beyond 3 years.
Consecutive case series of 39 eyes in 32 patients. Trabeculectomy was performed using fornix-based conjunctival flap, standard trabeculectomy punch, adjustable scleral flap sutures and antimetabolite treatment. Primary outcome of surgical failure was defined by two criteria: (A) need for further surgery, glaucoma medications or an intraocular pressure (IOP) >21 mm Hg during >10% of follow-up; or (B) IOP >15 mm Hg for >10% follow-up. A relatively aggressive regime of bleb needling and subconjunctival injections was used postoperatively in an attempt to reduce bleb fibrosis and failure. The mean follow-up was 42 months (range 25-55).
The rate of surgical failure was 4.4% per eye-year for criterion A, and 8.0% per eye-year for criterion B. Complications were few and compared favourably with other published series.
The Safe Surgery System for trabeculectomy provides excellent IOP control both during the operation and in the short and medium term postoperatively, with few complications or surgical failures.
评估安全手术系统小梁切除术超过3年的安全性及成功率。
对32例患者的39只眼进行连续病例系列研究。采用以穹窿为基底的结膜瓣、标准小梁切除打孔器、可调节巩膜瓣缝线及抗代谢药物治疗行小梁切除术。手术失败的主要结局由两个标准定义：(A) 在超过10%的随访期内需要进一步手术、使用青光眼药物或眼压（IOP）>21 mmHg；或(B) 在超过10%的随访期内眼压>15 mmHg。术后采用相对积极的滤泡针刺和结膜下注射方案，以试图减少滤泡纤维化和手术失败。平均随访时间为42个月（范围25 - 55个月）。
标准A的手术失败率为每眼每年4.4%，标准B为每眼每年8.0%。并发症较少，与其他已发表系列相比情况良好。
安全手术系统小梁切除术在手术期间以及术后短期和中期均能很好地控制眼压，并发症和手术失败较少。
