Heng Hah Moon, Norliza Raja Omar Raja, Jalaluddin Juliana, Fadzillah Abd Jalil Nor, Selvathurai Anusiah
Department of Ophthalmology, Hospital Melaka, Malaysia.
Int J Ophthalmol. 2012;5(3):384-8. doi: 10.3980/j.issn.2222-3959.2012.03.26. Epub 2012 Jun 18.
To study the success and outcome of trabeculectomy in Hospital Melaka.
Medical records of all patients who underwent trabeculectomy between January 1, 2007 and October 31, 2010 whom were followed up for at least 6 months postoperatively in Hospital Melaka were retrospectively reviewed.
A total number of 117 eyes of 91 patients with the age range between 12 to 84 years underwent primary trabeculectomy (n=20, 17.1%), combine trabeculectomy with cataract surgery (n=90, 76.9%), repeat trabeculectomy (n=5, 4.3%), and combine repeat trabeculectomy with cataract surgery (n=2, 1.7%). The disease spectrum includes primary open-angle glaucoma (POAG) (54 patients, 59.3%), priamry angle-closure glaucoma (PACG) (14 patients, 15.4%), secondary glaucomas (19 patients, 20.9%) and juvenile glaucomas (4 patients, 4.4%). Preoperative mean intraocular pressure (IOP) was (24.69±8.67)mmHg as compared to postoperative mean IOP of (15.81±6.66)mmHg, (15.07±4.72)mmHg and (15.68 ±3.65)mmHg at 6-month, 12-month and 24-month respectively. Eighty-two point one percent of eyes (n=96) achieved complete success (CS), 12.8% (n=15) with qualified success (QS) and only 5.1% (n=6) failed at 6 month with two of them warrant other filtering surgery. At twelve months, trabeculectomy with CS was 71.6% (n=63), QS in 22.7% (n=20) and failure in 5.7% (n=5). Sixty-seven point five percent (n=27) attained CS, 20.0% (n=8) with QS while 12.5% (n=5) failed at 24 month postoperative.
As the understanding of the lower the IOP, the better the patients retaining the visual function, trabeculectomy is significantly a choice of treatment in uncontrolled glaucoma. This study concluded that trabeculectomy performed in Hospital Melaka has produced significant success as compared to other studies.
研究马六甲医院小梁切除术的成功率及疗效。
回顾性分析2007年1月1日至2010年10月31日期间在马六甲医院接受小梁切除术且术后至少随访6个月的所有患者的病历。
91例患者共117只眼接受了手术,年龄范围为12至84岁。其中,原发性小梁切除术(n = 20,17.1%),小梁切除术联合白内障手术(n = 90,76.9%),重复小梁切除术(n = 5,4.3%),重复小梁切除术联合白内障手术(n = 2,1.7%)。疾病谱包括原发性开角型青光眼(POAG)(54例,59.3%),原发性闭角型青光眼(PACG)(14例,15.4%),继发性青光眼(19例,20.9%)和青少年青光眼(4例,4.4%)。术前平均眼压(IOP)为(24.69±8.67)mmHg,术后6个月、12个月和24个月的平均眼压分别为(15.81±6.66)mmHg、(15.07±4.72)mmHg和(15.68 ±3.65)mmHg。6个月时,82.1%(n = 96)的患眼获得完全成功(CS),12.8%(n = 15)获得合格成功(QS),仅5.1%(n = 6)失败,其中2例需要进行其他滤过手术。12个月时,小梁切除术获得CS的比例为71.6%(n = 63),QS为22.7%(n = 20),失败率为5.7%(n = 5)。术后24个月,67.5%(n = 27)获得CS,20.0%(n = 8)获得QS,12.5%(n = 5)失败。
鉴于对眼压越低患者视功能保留越好的认识,小梁切除术显然是治疗难治性青光眼的一种选择。本研究得出结论,与其他研究相比,在马六甲医院进行的小梁切除术取得了显著成功。