Sanders R, MacEwen C J, Haining W M
Department of Ophthalmology, Ninewells Hospital & Medical School, Dundee, UK.
Eye (Lond). 1993;7 ( Pt 3):440-3. doi: 10.1038/eye.1993.88.
Trabeculectomy reduces intraocular pressure by fistula formation into a subconjunctival bleb. The operation site traditionally has been at the superior corneo-scleral junction with a failure rate of 10-30%. The causes of trabeculectomy failure can be broadly classified into intraocular, scleral and extraocular. Extraocular factors account for the majority of failures, the main cause being increased subconjunctival fibrosis. Hitherto the effect of varying the site of filtration surgery on intraocular pressure control has not been studied. We therefore carried out a prospective study to evaluate the optimum site for trabeculectomy. Sixty patients were randomised to undergo a superior, nasal or temporal trabeculectomy. Patients who underwent a nasal trabeculectomy had significantly lower intraocular pressures 18 months after surgery (p < 0.05), with 30% having an intraocular pressure of < or = 10 mmHg.
小梁切除术通过在结膜下形成滤泡的瘘管来降低眼压。传统上，手术部位位于角膜巩膜上缘，失败率为10% - 30%。小梁切除术失败的原因大致可分为眼内、巩膜和眼外因素。眼外因素占失败原因的大多数，主要原因是结膜下纤维化增加。迄今为止，尚未研究改变滤过性手术部位对眼压控制的影响。因此，我们进行了一项前瞻性研究，以评估小梁切除术的最佳部位。60例患者被随机分为接受上方、鼻侧或颞侧小梁切除术。接受鼻侧小梁切除术的患者在术后18个月眼压显著降低（p < 0.05），30%的患者眼压≤10 mmHg。
