Konuganti Prakriti Yagnam, Rajamani Muralidhar, Chaya Craig John, Ramamurthy Chitra
Department of Glaucoma, The Eye Foundation, Coimbatore, Tamil Nadu, India.
Moran Eye Centre, Salt Lake City, Utah, USA.
J Curr Ophthalmol. 2024 Oct 16;36(1):23-30. doi: 10.4103/joco.joco_241_23. eCollection 2024 Jan-Mar.
To determine the short-term outcomes of a modified Moorfields Safer Surgery System technique of trabeculectomy.
This is a prospective interventional study. Trabeculectomy was performed according to the author's modification of Moorfields Safer Surgery System. This method allows titrating the opening pressure of trabeculectomy by varying the side cuts, varying the ostium size, and adjusting the tightness of the sutures. Forty-four eyes of 43 patients were included. Main outcome measures include postoperative intraocular pressure (IOP), incidence of intra and postoperative complications, and success up to 6 months after surgery.
The mean preoperative and postoperative IOP at 6 months were 20.97 ± 7.93 mmHg and 12.69 ± 4.76 mmHg, respectively ( = 44). 70.5% of the patients had absolute success at 6 months, and the overall success was 88.6%. None of the patients had hypotony and there were no intraoperative complications noted. Forty-two out of 44 eyes (95.5%) had diffuse formed blebs without leak on the 1 postoperative day. The most common postoperative complication (13.6%) was a conjunctival leak that was detected on fluorescein staining. In all these patients, the anterior chamber was deep, and the bleb well formed. These leaks were resolved with conservative measures. Many of these leaks would have been missed if not intentionally looked for. Excluding this complication, we had a complication rate of 9.1%.
The authors' modification of the Moorfields Safer Surgery System technique may allow the surgeon to optimize aqueous flow through trabeculectomy while mitigating complications.
确定改良的摩尔菲尔德更安全手术系统小梁切除术的短期疗效。
这是一项前瞻性干预性研究。小梁切除术根据作者对摩尔菲尔德更安全手术系统的改良进行。该方法可通过改变侧切口、改变造口大小和调整缝线松紧度来滴定小梁切除术的开放压力。纳入了43例患者的44只眼。主要观察指标包括术后眼压（IOP）、术中及术后并发症的发生率以及术后6个月内的成功率。
6个月时术前和术后平均眼压分别为20.97±7.93 mmHg和12.69±4.76 mmHg（n = 44）。70.5%的患者在6个月时获得绝对成功，总体成功率为88.6%。所有患者均未发生低眼压，术中未发现并发症。44只眼中有42只（95.5%）在术后第1天形成弥漫性无渗漏的滤过泡。最常见的术后并发症（13.6%）是荧光素染色检测到的结膜渗漏。在所有这些患者中，前房深，滤过泡形成良好。这些渗漏通过保守措施得以解决。如果不是特意寻找，许多这些渗漏可能会被遗漏。排除该并发症后，我们的并发症发生率为9.1%。
作者对摩尔菲尔德更安全手术系统技术的改良可能使外科医生在减轻并发症的同时优化小梁切除术中房水的流动。
