SooHoo Jeffrey R, Seibold Leonard K, Kahook Malik Y
Department of Ophthalmology, University of Colorado Eye Center, Aurora, USA.
Middle East Afr J Ophthalmol. 2015 Jan-Mar;22(1):25-9. doi: 10.4103/0974-9233.148345.
Glaucoma is a potentially blinding disease that affects millions of people worldwide. The mainstay of treatment is lowering of intraocular pressure (IOP) through the use of medications, laser and/or incisional surgery. The trabecular meshwork (TM) is thought to be the site of significant resistance to aqueous outflow in open angle glaucoma. Theoretically, an incision through TM or TM removal should decrease this resistance and lead to a significant reduction in IOP. This approach, commonly referred to as goniotomy or trabeculotomy, has been validated in the pediatric population and has been associated with long-term IOP control. In adults, however, removal of TM tissue has been historically associated with more limited and short-lived success. More recent evidence, reveals that even adult patients may benefit significantly from removal of diseased TM tissue and can lead to a significant reduction in IOP that is long-lasting and safe. In this review, we discuss current evidence and techniques for ab interno trabeculectomy using various devices in the adult patient.
青光眼是一种可能导致失明的疾病，全球数百万人受其影响。治疗的主要方法是通过使用药物、激光和/或切开手术来降低眼压（IOP）。小梁网（TM）被认为是开角型青光眼中房水流出显著阻力的部位。理论上，通过TM的切口或TM切除应降低这种阻力并导致IOP显著降低。这种方法通常称为前房角切开术或小梁切开术，已在儿科人群中得到验证，并与长期眼压控制相关。然而，在成人中，TM组织的切除在历史上与更有限和短暂的成功相关。最近的证据表明，即使是成年患者，切除患病的TM组织也可能显著受益，并可导致IOP显著降低，且这种降低是持久且安全的。在这篇综述中，我们讨论了使用各种设备对成年患者进行内路小梁切除术的当前证据和技术。
