Mosaed Sameh, Dustin Laurie, Minckler Don S
Gavin S. Herbert Eye Institute, University of California, Irvine, USA.
Trans Am Ophthalmol Soc. 2009 Dec;107:127-33.
To compare outcomes across Trabectome, iScience (canaloplasty), trabeculectomy, and aqueous shunts regarding intraocular pressure (IOP), adjunctive medications, and complications after glaucoma-only and combined glaucoma-phacoemulsification surgeries for open-angle glaucomas.
A literature review compares success rates, complications, efficacy, and limitations of traditional and novel glaucoma surgical procedures.
Trabectome and canaloplasty provide modest IOP reduction with minimal intraoperative or postoperative complications. Results of Baerveldt glaucoma implant IOP reduction are comparable to trabeculectomy, but typically this shunt requires more postoperative IOP-lowering medication to achieve a success rate comparable to trabeculectomy.
Trabeculectomy is still the most effective IOP-lowering procedure performed today but continues to have the highest serious complication rates. Trabectome and canaloplasty are reasonable surgical therapy choices for patients in which IOPs in the mid-teens seem adequate.
比较小梁切除术、iScience（房角成形术）、小梁切开术和房水引流装置在仅行青光眼手术以及青光眼合并白内障超声乳化手术治疗开角型青光眼后的眼压、辅助用药及并发症方面的疗效。
通过文献综述比较传统和新型青光眼手术的成功率、并发症、疗效及局限性。
小梁切除术和房角成形术能适度降低眼压，术中及术后并发症极少。Baerveldt青光眼引流植入物降低眼压的效果与小梁切除术相当，但通常这种引流装置术后需要更多降低眼压的药物才能达到与小梁切除术相当的成功率。
小梁切除术仍是目前最有效的降低眼压手术，但严重并发症发生率仍最高。对于眼压在十几mmHg左右似乎足够的患者，小梁切除术和房角成形术是合理的手术治疗选择。
