Shmyreva V F, Krasnov M M, Mostovoĭ E N
Vestn Oftalmol. 1989 Sep-Oct;105(5):8-12.
The authors give theoretical grounds and experimental validation for surgery on the optic nerve to eliminate its atrophic changes in glaucoma. They suggest a technique of the direct intervention at the site of the optic disk, approaching it from the side of the eye cavity. A method for the optic nerve decompression at the site of its stem portion via an extraocular approach is suggested. Experimental studies have demonstrated the possibility of enlarging the volume of the optic nerve scleral canal by discission of its narrowest section, the scleral ring; this operation essentially decreases twisting and deformation of the nerve fibers and main vessels of the retina. Clinical results of decompression surgery in 32 patients with far-progressed glaucoma are analyzed. Improvement of the visual function and stabilization of the glaucomatous process were observed in all the patients both in the immediate and late postoperative periods. The retinal and optic nerve blood microcirculation were found to improve after the suggested decompression surgery.
作者为青光眼视神经萎缩性改变的手术治疗提供了理论依据和实验验证。他们提出了一种从眼腔侧方接近视盘部位进行直接干预的技术。建议采用一种经眼外途径对视神经干段进行减压的方法。实验研究表明，通过切开视神经最狭窄部分巩膜环来扩大视神经巩膜管容积是可行的；该手术可显著减少视网膜神经纤维和主要血管的扭曲及变形。分析了32例晚期青光眼患者减压手术的临床结果。在术后即刻及晚期，所有患者的视功能均有改善，青光眼病情得到稳定。经建议的减压手术后，视网膜和视神经的微循环得到改善。
