Traverso C E, Tomey K F, al-Kaff A
King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia.
Int Ophthalmol. 1989 Jan;13(1-2):159-62. doi: 10.1007/BF02028657.
One hundred cases of recalcitrant glaucoma were operated with a long tube single-plate Molteno implant (LSMI). At the median follow-up of 15 months an intraocular pressure of less than or equal to 19 mm Hg was obtained in 64 of the 87 eyes (73%) which have a minimum follow-up of 6 months (secondary non-neovascular glaucomas = 19; congenital glaucomas = 26; secondary neovascular glaucomas = 12). The interval probability (percentage +/- standard error) of obtaining a successful result (IOP less than or equal to 19 mm Hg) was 79% (+/- 13) at twelve months from surgery, and 53% (+/- 24) at the eighteen month interval. The least favorable results were obtained in the secondary non-neovascular glaucomas. Complications observed included choroidal detachment (24%), tube exposure (4%), tube-endothelium contact (6%), plus band keratopathy, fibrous ingrowth, traction retinal detachment and corneal ulcers. Seventeen cases needed repeated surgery for the management of complications. In order to decrease the post-operative hypotony, we have been using a tourniquet suture around the tube at the time of implantation to occlude it temporarily and limit the outflow.
对100例顽固性青光眼患者施行长管单板莫尔顿植入物（LSMI）手术。在15个月的中位随访期，87只眼中有64只（73%）眼压降至或等于19 mmHg，这些眼至少随访了6个月（继发性非新生血管性青光眼=19例；先天性青光眼=26例；继发性新生血管性青光眼=12例）。术后12个月获得成功结果（眼压≤19 mmHg）的区间概率（百分比±标准误）为79%（±13），18个月时为53%（±24）。继发性非新生血管性青光眼的手术效果最差。观察到的并发症包括脉络膜脱离（24%）、引流管外露（4%）、引流管与内皮接触（6%），以及带状角膜病变、纤维组织长入、牵拉性视网膜脱离和角膜溃疡。17例患者因并发症需要再次手术。为了降低术后低眼压，我们在植入时使用止血缝线环绕引流管以暂时阻塞并限制房水流出。
