L'Esperance F A, Mittl R N, James W A
Ophthalmology. 1983 Jul;90(7):821-9. doi: 10.1016/s0161-6420(83)34497-3.
During the past 24 months, 23 cases of advanced neovascular glaucoma, unresponsive to medical therapy, have been treated by a trabeculostomy procedure using a carbon dioxide laser. This procedure entails surgical entry into the anterior chamber from beneath either a conjunctival or scleral flap in such a way as to completely cauterize any neovascular tissue in the corneoscleral angle and to permit adequate drainage of the aqueous in fluid from the anterior chamber to the periocular space. The average intraocular pressure prior to carbon dioxide laser trabeculostomy was 54 mmHg and these pressures were lowered below 18 mmHg in over 70% of the cases followed for longer than six months postlaser therapy. Treatment was considered a failure in 16% of the cases where the intraocular pressure was not lowered substantially. Fourteen percent of the treated eyes sustained a pressure decrease to within the 26-35 mmHg range. Carbon dioxide laser trabeculostomy provides a new method of lowering the intraocular pressure in severe cases of neovascular glaucoma without the hazard of intraocular hemorrhage common with other filtration procedures or the ciliary destruction present with the cyclocautery operations. The indications, surgical technique, and complications will be discussed.
在过去24个月中，23例对药物治疗无反应的晚期新生血管性青光眼患者接受了二氧化碳激光小梁切开术治疗。该手术需要通过结膜瓣或巩膜瓣从下方进入前房，以便完全烧灼角膜巩膜角的任何新生血管组织，并使房水从前房充分引流到眼周间隙。二氧化碳激光小梁切开术前的平均眼压为54 mmHg，在激光治疗后随访超过6个月的病例中，超过70%的眼压降至18 mmHg以下。16%的病例眼压未显著降低，治疗被认为失败。14%的治疗眼眼压降至26 - 35 mmHg范围内。二氧化碳激光小梁切开术为严重新生血管性青光眼病例降低眼压提供了一种新方法，没有其他滤过手术常见的眼内出血风险或睫状体破坏手术存在的睫状体破坏风险。将讨论其适应症、手术技术和并发症。
