Melamed S, Neumann D, Blumenthal M
Goldschleger Eye Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Int Ophthalmol. 1991 May;15(3):157-62. doi: 10.1007/BF00153920.
In 15 eyes with uncontrolled aphakic/pseudophakic glaucoma, trabeculectomy with anterior vitrectomy was performed. Mean pre-operative intraocular pressure (IOP) was 38.2 +/- 6.7 mmHg and mean post operative IOP was 19.3 +/- 5.2 mmHg after follow-up of 11.2 2 months. The anterior chamber maintainer technique during vitrectomy has been employed. Success rate (IOP less than 21 mmHg with or without glaucoma medication) was 80%. Visual acuity remained unchanged in 4 eyes, improved in 5 eyes and worsened in 6 eyes. Postoperative complications included: two eyes with cystoid macular edema, two eyes with choroidal effusion and prolonged hypotony, one eye with self-absorbing vitreous hemorrhage and one eye with some opacification of the corneal graft. In aphakic/pseudophakic glaucoma where vitreous is filling the anterior chamber--a combined trabeculectomy with anterior vitrectomy is indicated for removal of vitreous from the sclerostomy site with better aqueous flow through the sclerostomy and adequate control of IOP.
对15例药物治疗无法控制的无晶状体/人工晶状体性青光眼患者实施了小梁切除术联合前部玻璃体切除术。术前平均眼压(IOP)为38.2±6.7 mmHg,随访11.2±2个月后,术后平均眼压为19.3±5.2 mmHg。玻璃体切除术中采用了前房维持器技术。成功率(使用或不使用青光眼药物治疗时眼压低于21 mmHg)为80%。4只眼视力保持不变,5只眼视力提高,6只眼视力下降。术后并发症包括:2只眼发生黄斑囊样水肿,2只眼发生脉络膜渗漏和持续性低眼压,1只眼发生自发性吸收的玻璃体积血,1只眼角膜移植片出现一些混浊。在玻璃体填充前房的无晶状体/人工晶状体性青光眼中,小梁切除术联合前部玻璃体切除术适用于从巩膜造瘘口处清除玻璃体,使房水更好地通过巩膜造瘘口流动,并充分控制眼压。