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小梁切除术后滤过泡并发症的处理

Management of bleb complications after trabeculectomy.

作者信息

Leung Dexter Y L, Tham Clement C Y

机构信息

Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, The People's Republic of China.

出版信息

Semin Ophthalmol. 2013 May;28(3):144-56. doi: 10.3109/08820538.2013.771199.

Abstract

Trabeculectomy remains a mainstay surgery for glaucoma. The necessity to raise a bleb and use of chemoadjuvants may result in bleb-related complications, such as bleb-fibrosis, bleb-leaks, bleb-related infections, overfiltration, or hypotony. This review highlights some of the latest developments in preventing and managing these complications, including anti-vascular endothelial growth factors, monoclonal antibodies for moderate reduction of fibrosis, newer surgical strategies for bleb leaks, an update from a randomized clinical trial highlighting the incidence and management of bleb-related infections, and various treatment strategies for an overfiltering bleb. In addition, other surgical interventions with less or no bleb-related complications will be discussed, including non-penetrating glaucoma surgeries, glaucoma drainage devices, or phacoemulsification.

摘要

小梁切除术仍然是青光眼的主要手术方式。形成滤过泡的必要性以及化学辅助剂的使用可能会导致与滤过泡相关的并发症,如滤过泡纤维化、滤过泡渗漏、滤过泡相关感染、过度滤过或低眼压。本综述重点介绍了预防和处理这些并发症的一些最新进展,包括抗血管内皮生长因子、用于适度减少纤维化的单克隆抗体、针对滤过泡渗漏的新手术策略、一项强调滤过泡相关感染的发生率及处理的随机临床试验的最新情况,以及针对过度滤过性滤过泡的各种治疗策略。此外,还将讨论其他与滤过泡相关并发症较少或无相关并发症的手术干预措施,包括非穿透性青光眼手术、青光眼引流装置或超声乳化术。

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