Georgetown University/Washington Hospital Center, USA.
J Glaucoma. 2010 Sep;19(7):497-8. doi: 10.1097/IJG.0b013e3181c4b113.
To describe a new, in-office procedure for limiting symptomatic, circumferential conjunctival blebs occurring after trabeculectomy.
Two eyes of 2 patients status postfornix-based trabeculectomy with mitomycin C were found to have symptomatic circumferential blebs.
Risks and benefits of cautery were discussed, along with alternatives including continued conservative treatment or surgical revision. The patients opted for in-office cautery. Two eyes of 2 patients underwent cauterization of their blebs with a Bovie high temperature handheld cautery in the office after topical pretreatment with 2.5% neosynephrine and 4% xylocaine. Excess fluid was drained from the bleb by expression through the puncture wounds. The wounds were Seidel negative immediately after the treatment.
Flattening of the bleb occurred instantly, patients did not experience pain and their symptoms related to the extensive bleb resolved. The functioning of the bleb was not altered in these 2 cases by this procedure.
Early results show that handheld cautery may be a useful means of treating symptomatic circumferential blebs.
描述一种新的门诊手术方法，用于限制小梁切除术后出现的症状性、环形结膜滤泡。
2 例患者因穹窿部为基底的小梁切除术后应用丝裂霉素 C 而出现症状性环形滤泡，行该手术。
讨论了烧灼的风险和益处，以及包括继续保守治疗或手术修正在内的替代方案。患者选择了门诊烧灼。对 2 例患者的 2 只眼进行了滤泡烧灼，在局部预处理 2.5%新福林和 4%可卡因后，用 Bovie 高温手持电烙器进行烧灼。通过穿刺伤口引流多余的液体。治疗后，伤口立即 Seidel 阴性。
滤泡即刻变平，患者无疼痛，与广泛滤泡相关的症状得到缓解。在这 2 例中，该手术并未改变滤泡的功能。
早期结果表明，手持电烙器可能是治疗症状性环形滤泡的一种有用方法。
