Kashintseva L T, Teliushchenko V D
Oftalmol Zh. 1990(2):65-9.
The paper describes results after surgical treatment of patients with initial exfoliative glaucoma in 150 eyes. Of them, sinusotrabeculectomy (STET) was made in 49 eyes, sinusotrabeculotomy (STT)--in 50, a new, proposed by the authors, operation--a "cap peak" sinusotrabeculotomy (CPSTT)--in 66 eyes; the latter excludes direct fistulization of the anterior chamber under the superficial scleral flap. It is noted that CPSTT at initial exfoliative stage of glaucoma leads to a remarkably lower incidence of complications at the time of operation and early postoperative period. Hyphema and anterior chamber emptying were recorded at the time of STET in 22.4% and 16.3%, of STT--in 8.0% and 10.0%, while at the time of CPSTT--only in 3.0% and 1.5%, respectively. Iridocyclitis, flat anterior chamber and detachment of the choroid were observed after STET in 32.6%, 24.5% and 26.5%, after STT--in 22.0%, 14.0% and 16.0%, and after CPSTT--in 6.0%, 4.5% and 1.5%, respectively. In remote terms (3 years after the operations), stabilization of visual acuity and visual field was recorded after STET in 69.3% and 85.7%, after STT--in 82.0% and 90.0%, and after CPSTT--in 87.9% and 92.4%, respectively. Stable normalization of intraocular pressure took place after STET in 93.8%, after STT--in 98.0%, and after CPSTT--in 96.9%. After STET and STT, hypotony was recorded in 28.5% and 18.0%, respectively, and after CPSTT--in none of the cases. The operation of a "cap peak" sinusotrabeculotomy is proposed as an operation of choice for treatment of exfoliative and common open-angle glaucomas in persons above 65 years of age.
该论文描述了150只眼原发性剥脱性青光眼患者手术治疗后的结果。其中，49只眼行窦小梁切除术（STET），50只眼行窦小梁切开术（STT），66只眼行作者提出的一种新手术——“帽峰”窦小梁切开术（CPSTT）；后者可避免浅层巩膜瓣下前房直接形成瘘管。值得注意的是，青光眼剥脱初期行CPSTT可使手术时及术后早期并发症发生率显著降低。STET时前房积血和前房消失的发生率分别为22.4%和16.3%，STT时分别为8.0%和10.0%，而CPSTT时仅分别为3.0%和1.5%。STET后虹膜睫状体炎、无前房和脉络膜脱离的发生率分别为32.6%、24.5%和26.5%，STT后分别为22.0%、14.0%和16.0%，CPSTT后分别为6.0%、4.5%和1.5%。远期（术后3年），STET后视力和视野稳定的发生率分别为69.3%和85.7%，STT后分别为82.0%和90.0%，CPSTT后分别为87.9%和92.4%。STET后眼压稳定正常化的发生率为93.8%，STT后为98.0%，CPSTT后为96.9%。STET和STT后低眼压发生率分别为28.5%和18.0%，CPSTT后无一例发生低眼压。“帽峰”窦小梁切开术被推荐为65岁以上剥脱性和普通开角型青光眼患者的首选手术。
