Krivitskiĭ A K, Kozina L V
Oftalmol Zh. 1990(2):69-73.
In order to study effectiveness of surgical treatment in patients with glaucoma in association with atherosclerosis or diabetes mellitus, remote observations (from 1 to 8 years) were carried out over 216 patients operated at different stages of the glaucomatous process: at the initial stage--104 eyes, at the advanced--87, and the far-advanced--53 eyes. Sinusotrabeculectomy in the author's modification was used: at first the external wall of the Schlemm's canal was removed, then the trabecula was destroyed by a blunt spatula, gradually letting out the chamber aqueous. The observations carried out have shown that surgical treatment of glaucoma in patients with atherosclerosis is more effective at the initial and advanced stages. In patients with glaucoma and diabetes mellitus, surgical treatment was most effective in persons with initial stage of glaucoma. It should be noted here that surgical treatment at initial stage of glaucoma allows to preserve high visual functions for a long period of time. Stabilization of the process in persons operated at the initial stage was achieved in 95-97% of cases. This gives grounds to recommend surgical treatment of glaucoma in patients with atherosclerosis and diabetes mellitus at the initial stage of the glaucomatous process. The fall of intraocular pressure is mainly connected with improvement of the aqueous outflow.
为研究青光眼合并动脉粥样硬化或糖尿病患者手术治疗的效果，对216例在青光眼病程不同阶段接受手术的患者进行了为期1至8年的远程观察：初始阶段104只眼，进展期87只眼，晚期53只眼。采用了作者改良的鼻窦小梁切除术：首先切除施莱姆管的外壁，然后用钝头刮匙破坏小梁，逐渐放出房水。观察结果表明，动脉粥样硬化患者青光眼的手术治疗在初始和进展期更有效。在青光眼合并糖尿病患者中，手术治疗对青光眼初始阶段的患者最有效。在此应指出，青光眼初始阶段的手术治疗可长期保持较高的视功能。在初始阶段接受手术的患者中，95%至97%的病例病情得到稳定。这为推荐在青光眼病程初始阶段对动脉粥样硬化和糖尿病患者进行青光眼手术治疗提供了依据。眼压下降主要与房水流出改善有关。
