Sofi Rayees Ahmad, Shafi Shahnawaz, Qureshi Waseem, Ashraf Sehrish
Department of Ophthalmology, Government Medical College, Srinagar, Jammu and Kashmir, India.
Registrar, Government Medical College, Srinagar, Jammu and Kashmir, India.
Int J Health Sci (Qassim). 2018 Mar-Apr;12(2):57-60.
The aim of the study was to evaluate intraocular pressure (IOP) control, potential benefits, and associated complications in advanced cases of glaucoma (visual acuity of <6/60) after trabeculectomy. Although many studies of trabeculectomy in glaucoma patients have been done, very few in such advanced cases.
The study was done on 60 cases of advanced primary open-angle glaucoma (POAG). Trabeculectomy was done and IOP control was assessed. Pre-operative workup included a detailed history, slit lamp biomicroscopy, Goldmann applanation tonometry, gonioscopy using Goldmann 2 mirror lens, and detailed fundus examination with the 78D lens. All the patients were to undergo optical coherence tomography and Humphrey automated perimetry.
Out of 60 patients with POAG, 48 were males and 12 were females with a ratio of 4:1. Of all the 60 cases, 36 had a visual acuity of 20/200, 16 had a visual acuity of hand movements, and eight patients had a visual acuity of perception of light. The mean pre-operative IOP was measured as 37.01 mmHg with standard deviation (SD)± 8.82. The mean post-operative IOP was found 17.92 mmHg with SD ± 3.17. There was a mean drop of 19 mmHg of IOP postoperatively. P value was highly significant ( < 0.000).
Trabeculectomy is a successful method of controlling IOP in patients with advanced glaucoma. Trabeculectomy is the method of reducing IOP in medically uncontrolled patients. A pain-free eye was associated with better quality of life in patients. A successful trabeculectomy helps to preserve the residual vision in such patients.
本研究旨在评估小梁切除术后晚期青光眼（视力<6/60）患者的眼压控制情况、潜在益处及相关并发症。虽然已经对青光眼患者小梁切除术进行了许多研究，但针对此类晚期病例的研究却很少。
对60例晚期原发性开角型青光眼（POAG）患者进行了研究。实施小梁切除术并评估眼压控制情况。术前检查包括详细病史、裂隙灯生物显微镜检查、Goldmann压平眼压测量法、使用Goldmann 2镜透镜进行房角镜检查以及使用78D透镜进行详细眼底检查。所有患者均需接受光学相干断层扫描和Humphrey自动视野计检查。
在60例POAG患者中，男性48例，女性12例，比例为4:1。60例患者中，36例视力为20/200，16例视力为手动，8例患者视力为光感。术前平均眼压测量值为37.01 mmHg，标准差（SD）±8.82。术后平均眼压为17.92 mmHg，SD±3.17。术后眼压平均下降了19 mmHg。P值具有高度显著性（<0.000）。
小梁切除术是控制晚期青光眼患者眼压的一种成功方法。小梁切除术是降低药物治疗无法控制眼压患者眼压的方法。无痛眼与患者更好的生活质量相关。成功的小梁切除术有助于保留此类患者的残余视力。
