Scheie H G
Int Ophthalmol Clin. 1981 Spring;21(1):41-6. doi: 10.1097/00004397-198102110-00006.
I have described modifications that have evolved over the years in doing iridectomy with cautery and have reviewed some of my experiences with the method. All filtering operations leave a great deal to be desired. Each technique has certain advantages and disadvantages. A great advantage of the cautery procedure is its safety and simplicity. It is as effective in lowering pressure as most other procedures. Even if the operation fails to control pressure, little harm is done to the eye, and it can be repeated. One of the great advances in management of open-angle glaucoma in recent years has been the adoption of stringent indications for surgery. Surgery should not be advised until a thorough trial of maximal medical therapy has been made. In many instances, however, the pendulum has been allowed to swing too far. When medical treatment has failed, and the patient is faced with progressive loss of vision if control of pressure is not achieved, the ophthalmic surgeon should resist the temptation to procrastinate. Surgery should be done promptly and deterioration should not be allowed to occur. Should a cataract occur, it can be removed. Endophthalmitis can be prevented or cured by antibiotic therapy. Although filtering operations leave a great deal to be desired, when effective, they will preserve a functioning optic nerve.
我已经描述了多年来在进行烧灼性虹膜切除术时所采用的改进方法，并回顾了我在该方法上的一些经验。所有的滤过性手术都有很多不足之处。每种技术都有其优缺点。烧灼术的一个很大优点是其安全性和简便性。它在降低眼压方面与大多数其他手术一样有效。即使手术未能控制眼压，对眼睛造成的损害也很小，并且可以重复进行。近年来开角型青光眼治疗方面的一大进展是采用了严格的手术指征。在对最大程度的药物治疗进行全面试验之前，不应建议进行手术。然而，在许多情况下，这种倾向已经过头了。当药物治疗失败，且如果眼压得不到控制患者将面临视力逐渐丧失时，眼科医生应抵制拖延的诱惑。应立即进行手术，不应任其病情恶化。如果发生白内障，可以将其摘除。眼内炎可以通过抗生素治疗预防或治愈。虽然滤过性手术有很多不足之处，但如果有效，它们将保留功能正常的视神经。
