Jordan J F, Neuburger M, Reinhard T
Universitäts-Augenklinik Freiburg, Killianstraße 5, 79106, Freiburg.
Ophthalmologe. 2010 Sep;107(9):855-60. doi: 10.1007/s00347-010-2235-3.
The Trabectome provides a new perspective in angle surgery for open angle glaucoma. Through a 1.7 mm clear cornea tunnel, the juxtacanalicular meshwork is electroablated under gonioscopic control. Thereby, the collector channels in the outer wall of Schlemm's canal are uncovered and resistance to trabecular outflow is removed. From the literature and from our own experience, a pressure reduction by 30-35% can be achieved with a simultaneous reduction of eye drops by 50%. The Trabectome can conveniently be combined with phako-emulsification. Serious complications have not yet been reported. As the conjunctiva remains completely untouched, trabeculectomy, if necessary, could be performed without prognostic restrictions. With a realistic target pressure of approximately 16 mmHg, Trabectome surgery is indicated in patients with moderate optic nerve damage.
Trabectome为开角型青光眼的房角手术提供了新视角。通过一个1.7毫米的透明角膜隧道,在房角镜控制下对近小管组织进行电凝。从而,施莱姆管外壁的集合管得以暴露,小梁网流出阻力被消除。从文献和我们自己的经验来看,眼压可降低30%-35%,同时眼药水用量可减少50%。Trabectome可方便地与晶状体乳化术联合使用。尚未有严重并发症的报道。由于结膜完全未受影响,如有必要,小梁切除术可不受预后限制地进行。对于目标眼压约为16 mmHg的中度视神经损伤患者,可考虑行Trabectome手术。