Wu Zhen-Kai, Wu Jing, Tan Qian, Jiang Jian, Song Wei-Tao, Xia Xiao-Bo
Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410000, Hunan Province, China; Department of Ophthalmology, First People's Hospital of Changde City, Changde 415000, Hunan Province, China.
Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha 410000, Hunan Province, China.
Int J Ophthalmol. 2016 Feb 18;9(2):243-8. doi: 10.18240/ijo.2016.02.11. eCollection 2016.
To evaluate the therapeutic effect and the safety of the treatment of congenital glaucoma through modified combined trabeculotomy-trabeculectomy.
The clinical data of 27 cases (altogether 42 eyes), which included 7 cases of infants (10 eyes) and 20 cases of teenagers (32 eyes), of congenital glaucoma undertook modified combined trabeculotomy-trabeculectomy were analyzed retrospectively. The parameters evaluated included the post operation visual acuity, the anterior chamber, the filtering bleb, the intraocular pressure, the C/D ratio, visual field, the retinal nerve fiber layer changes and the complications.
The follow-up period was 1 to 29mo, averaging 13.3±7.7mo. Upon the last visit after the operation, functional filtering blebs developed in all the involved eyes. The intraocular pressure was controlled under 21 mm Hg, which was decreased by 60% when compared with that before the operation, without using any medication. There were no significant changes in the post operation visual acuity and the retinal nerve fiber layer thickness before and after the operation in teenager group (P>0.05), and both the post operation C/D ratio and the visual field mean defect (MD) were reduced compared with those before the operation (P<0.05). There were no severe complications in any of the patients.
The modified combined trabeculotomy-trabeculectomy can effectively reduce the intraocular pressure and control the development of glaucoma in cases of congenital glaucoma. It is a safe and effective operative method for the treatment of congenital glaucoma.
评估改良小梁切开术-小梁切除术治疗先天性青光眼的疗效及安全性。
回顾性分析27例（共42只眼）先天性青光眼患者行改良小梁切开术-小梁切除术的临床资料，其中婴儿7例（10只眼），青少年20例（32只眼）。评估参数包括术后视力、前房、滤过泡、眼压、杯盘比、视野、视网膜神经纤维层变化及并发症。
随访时间为1至29个月，平均13.3±7.7个月。术后末次随访时，所有患眼均形成功能性滤过泡。眼压控制在21 mmHg以下，与术前相比降低了60%，且未使用任何药物。青少年组术后视力及视网膜神经纤维层厚度与术前相比无显著变化（P>0.05），术后杯盘比及视野平均缺损（MD）均较术前降低（P<0.05）。所有患者均无严重并发症。
改良小梁切开术-小梁切除术可有效降低先天性青光眼患者的眼压，控制青光眼发展。是治疗先天性青光眼安全有效的手术方法。
