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[原发性青光眼的环钻小梁切除术与虹膜嵌顿术的比较结果]

[Comparative results of trepanotrabeculectomy and iridencleisis in primary glaucoma].

作者信息

Cvetkovic D, Blagojevic M, Dodic V

出版信息

J Fr Ophtalmol. 1979 Feb;2(2):103-7.

PMID:444110
Abstract

For the last 10 years 500 iridencleisis and 250 trepanotrabeculectomies were performed. For this study are subjected only 205 cases of basal and total iridencleisis and 100 cases of trepanotrabeculectomy, performed in chronic open and chronic closed angle glaucoma. The authors point out that some common factors play the role on the final results, independently of the type of the operation. It was observed that the results were worse in patients having the diabetes and/or arterial hypertension, when the operation is performed in the advanced age or in the late stage of glaucoma, and also if the eye was already operated. To evaluate the result of the operations (basal and total iridencleisis, trepanotrabeculectomy) the authors estimate that is not enough to take the intraocular tension as the unic parameter, one should take in consideration also the visual field, visual acuity and also the state of the optic disc in the follow-up period (see Tbl. 4). This period should not be shorter than one year. With the trepanotrabeculectomy (85%) and with total iridencleisis (86,5%) the intraocular tensions could be normalised in the higher percentage than with the basal iridencleisis (75,5%). On the other hand, if one take also the other parameters for the evaluation (visual field, visual acuity, status of the optic disc) one could conclude that the best result was achieved with trepanotrabeculectomy (80% the complete consolidation), and than with total iridencleisis (69,4%) or basal iridencleisis (67%). In trepanotrabeculectomy the peroperative and postoperative complications are rare.

摘要

在过去10年中,共进行了500例虹膜周边切除术和250例环钻小梁切除术。本研究仅纳入205例慢性开角型青光眼和慢性闭角型青光眼患者接受的基底虹膜周边切除术和全虹膜周边切除术,以及100例环钻小梁切除术。作者指出,一些共同因素对最终结果起作用,与手术类型无关。观察到,患有糖尿病和/或动脉高血压的患者、手术在高龄或青光眼晚期进行的患者,以及眼睛已经接受过手术的患者,手术结果较差。为了评估手术(基底虹膜周边切除术、全虹膜周边切除术、环钻小梁切除术)的效果,作者认为仅将眼压作为唯一参数是不够的,在随访期间还应考虑视野、视力以及视盘状态(见表4)。随访期不应短于一年。与基底虹膜周边切除术(75.5%)相比,环钻小梁切除术(85%)和全虹膜周边切除术(86.5%)能使更高比例的眼压恢复正常。另一方面,如果还考虑其他评估参数(视野、视力、视盘状态),可以得出结论,环钻小梁切除术的效果最佳(完全巩固率为80%),其次是全虹膜周边切除术(69.4%)或基底虹膜周边切除术(67%)。在环钻小梁切除术中,手术中和术后并发症很少见。

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