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小儿青光眼治疗的当前手术选择。

Current surgical options for the management of pediatric glaucoma.

作者信息

Morales Jose, Al Shahwan Sami, Al Odhayb Sami, Al Jadaan Ibrahim, Edward Deepak P

机构信息

King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh 11462, Saudi Arabia.

出版信息

J Ophthalmol. 2013;2013:763735. doi: 10.1155/2013/763735. Epub 2013 Apr 24.

Abstract

Currently, there are numerous choices for the treatment of pediatric glaucoma depending on the type of glaucoma, the age of the patient, and other particularities of the condition discussed in this review. Traditionally, goniotomy and trabeculotomy ab externo have been the preferred choices of treatment for congenital glaucoma, and a variety of adult procedures adapted to children have been utilized for other types of pediatric glaucoma with variable results and complications. More recently, seton implantations of different types have become more popular to use in children, and newer techniques have become available including visualized cannulation and opening of Schlemm's canal, deep sclerectomy, trabectome, and milder more directed cyclodestructive procedures such as endolaser and transcleral diode laser cyclophotocoagulation. This paper reviews the different surgical techniques currently available, their indications, results, and most common complications to allow the surgeon treating these conditions to make a more informed choice in each particular case. Although the outcome of surgical treatment in pediatric glaucoma has improved significantly, its treatment remains challenging.

摘要

目前,根据青光眼的类型、患者年龄以及本综述中讨论的病情其他特点,小儿青光眼的治疗有多种选择。传统上,前房角切开术和外路小梁切开术一直是先天性青光眼的首选治疗方法,并且已将多种适用于成人的手术应用于其他类型的小儿青光眼,但效果和并发症各不相同。最近,不同类型的引流管植入术在儿童中使用得越来越普遍,并且出现了更新的技术,包括可视化Schlemm管插管和开放、深层巩膜切除术、小梁切除术以及更温和、更有针对性的睫状体破坏手术,如内镜激光和经巩膜二极管激光睫状体光凝术。本文综述了目前可用的不同手术技术、其适应症、结果以及最常见的并发症,以便治疗这些疾病的外科医生在每个具体病例中做出更明智的选择。尽管小儿青光眼手术治疗的效果有了显著改善,但其治疗仍然具有挑战性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a20a/3655566/4a0dce3470f2/JOP2013-763735.001.jpg

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