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[小梁切除术后的伤口愈合:术后护理中关注什么及何时进行护理?]

[Wound healing after trabeculectomy : What and when in postoperative aftercare?].

作者信息

Martin Julien, Lübke Jan

机构信息

Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Kilianstr. 5, 79106, Freiburg, Deutschland.

出版信息

Ophthalmologie. 2024 May;121(5):427-437. doi: 10.1007/s00347-024-02041-5. Epub 2024 Apr 29.

DOI:10.1007/s00347-024-02041-5
PMID:38683364
Abstract

Excessive wound healing in filtering glaucoma surgery is a key factor for a failed surgery. After the introduction of trabeculectomy in the 1960s many factors associated with an increased fibrotic reaction were recognized and methods were developed to influence postoperative wound healing. These range from the perioperative use of anti-inflammatory drugs and antimetabolites to the use of newer chemical compounds that influence the morphology of postoperative fibroblast growth. In the routine clinical practice, the fine tuning of therapeutic decisions plays a decisive role in the success or failure of filtration surgery.

摘要

滤过性青光眼手术中过度的伤口愈合是手术失败的关键因素。自20世纪60年代小梁切除术问世以来,人们认识到许多与纤维化反应增加相关的因素,并开发了一些方法来影响术后伤口愈合。这些方法包括围手术期使用抗炎药物和抗代谢药物,以及使用影响术后成纤维细胞生长形态的新型化合物。在常规临床实践中,治疗决策的微调对滤过手术的成败起着决定性作用。

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1
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Ophthalmologie. 2024 May;121(5):427-437. doi: 10.1007/s00347-024-02041-5. Epub 2024 Apr 29.
2
5-Fluorouracil for glaucoma surgery.用于青光眼手术的5-氟尿嘧啶
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Antifibrotics and wound healing in glaucoma surgery.青光眼手术中的抗纤维化与伤口愈合
Surv Ophthalmol. 2003 May-Jun;48(3):314-46. doi: 10.1016/s0039-6257(03)00038-9.
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Anti-vascular endothelial growth factor for control of wound healing in glaucoma surgery.抗血管内皮生长因子用于控制青光眼手术中的伤口愈合
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Combined glaucoma filtration surgery and phacoemulsification.青光眼滤过手术联合白内障超声乳化吸除术
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Am J Ophthalmol. 2001 Nov;132(5):633-40. doi: 10.1016/s0002-9394(01)01178-3.
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Topical infliximab for the suppression of wound healing following experimental glaucoma filtration surgery.局部注射英夫利昔单抗对实验性青光眼滤过术后伤口愈合的抑制作用
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本文引用的文献

1
Guidelines for the management of open-angle glaucoma: National Program Area Eye Diseases, National Working Group Glaucoma.开角型青光眼管理指南:国家眼病项目地区,国家青光眼工作组
Acta Ophthalmol. 2024 Mar;102(2):135-150. doi: 10.1111/aos.16599. Epub 2024 Jan 2.
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European Glaucoma Society - A guide on surgical innovation for glaucoma.欧洲青光眼学会-青光眼手术创新指南。
Br J Ophthalmol. 2023 Dec 21;107(Suppl 1):1-114. doi: 10.1136/bjophthalmol-2023-egsguidelines.
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[Comparison of new and old procedures for glaucoma surgery : What, when, where, why?].
[青光眼手术新旧术式对比:是什么、何时、何地、为何?]
Ophthalmologie. 2023 Apr;120(4):348-349. doi: 10.1007/s00347-023-01836-2. Epub 2023 Apr 28.
4
Novel Therapies for the Prevention of Fibrosis in Glaucoma Filtration Surgery.青光眼滤过手术中预防纤维化的新型疗法。
Biomedicines. 2023 Feb 21;11(3):657. doi: 10.3390/biomedicines11030657.
5
Laser in Glaucoma and Ocular Hypertension (LiGHT) Trial: Six-Year Results of Primary Selective Laser Trabeculoplasty versus Eye Drops for the Treatment of Glaucoma and Ocular Hypertension.激光治疗青光眼和高眼压症(LiGHT)试验:原发性选择性激光小梁成形术与滴眼液治疗青光眼和高眼压症的六年结果。
Ophthalmology. 2023 Feb;130(2):139-151. doi: 10.1016/j.ophtha.2022.09.009. Epub 2022 Sep 17.
6
Primary Open-Angle Glaucoma Preferred Practice Pattern®.原发性开角型青光眼首选诊疗模式®
Ophthalmology. 2021 Jan;128(1):P71-P150. doi: 10.1016/j.ophtha.2020.10.022. Epub 2020 Nov 12.
7
[Corneal wound healing-Pathophysiology and principles].[角膜伤口愈合——病理生理学与原理]
Ophthalmologe. 2021 Nov;118(11):1167-1177. doi: 10.1007/s00347-021-01423-3. Epub 2021 Jun 9.
8
Long-term Functional Outcomes of Trabeculectomy Revision Surgery.青光眼滤过手术失败后行小梁切除术的长期功能预后。
Ophthalmol Glaucoma. 2019 Jul-Aug;2(4):240-250. doi: 10.1016/j.ogla.2019.04.003. Epub 2019 Apr 23.
9
A standardized protocol of laser suture lysis in postoperative management in trabeculectomy with mitomycin C: One-year study.丝裂霉素C小梁切除术后管理中激光缝线溶解的标准化方案:一年研究
Eur J Ophthalmol. 2021 Mar;31(2):477-481. doi: 10.1177/1120672120901699. Epub 2020 Jan 27.
10
Steroids and nonsteroidal anti-inflammatory drugs in the postoperative regime after trabeculectomy - which provides the better outcome? A systematic review and meta-analysis.术后应用皮质类固醇和非甾体类抗炎药治疗小梁切除术的效果比较:哪种方案的效果更好?系统评价和荟萃分析。
Acta Ophthalmol. 2019 Mar;97(2):146-157. doi: 10.1111/aos.13919. Epub 2018 Sep 21.