Kasparov A A, Malozhen S A
Vestn Oftalmol. 1993 Jan-Feb;109(1):6-8.
Two new methods for antiglaucoma draining surgery are suggested, consisting in perforating keratoplasty with elements of partial or complete reconstruction of the anterior segment of the eye in cases with combined injuries to the cornea and other structures, associated with secondary glaucoma. The first of these methods consists in conducting an 'active' draining tube, made of silicone, via the trabeculectomy site into the anterior chamber, the draining tube then being fixed to the iris in the ciliary zone; the drainage tube has an extra opening on its proximal end. The other method implies the creation of two new special routes for intraocular fluid discharge; a cyclodialysis opening is formed, through which a capillary drainage is introduced into the anterior chamber, that is fixed to the iris. To prevent over growing of the distal end of the drainage tube with tissues of the operated on eye it was placed in some patients under a silicone explant (sponge). Forty-five patients (45 eyes) were operated on making use of the former method and 23 patients (23 eyes) were operated on with the use of the latter method. The results were followed up for up to 3 years; intraocular pressure compensation was attained in 91.1% of cases, transparent and semitransparent taking in of perforated keratotransplants in 75.6%, vision acuity improvement from the right light projection up to 0.3 diopters and higher was observed in 62.2% of patients.
提出了两种抗青光眼引流手术的新方法，适用于角膜及其他结构合并损伤并伴有继发性青光眼的病例，手术包括在前房部分或完全重建的基础上进行穿透性角膜移植。第一种方法是通过小梁切除术部位将由硅胶制成的“活性”引流管置入前房，然后将引流管固定在睫状区的虹膜上；引流管近端有一个额外的开口。另一种方法是创建两条新的眼内液体排出特殊通道；形成一个睫状体分离开口，通过该开口将一根毛细管引流管引入前房，并固定在虹膜上。为防止引流管远端被术眼组织过度生长覆盖，部分患者将其置于硅胶外植体（海绵）下方。采用前一种方法对45例患者（45只眼）进行了手术，采用后一种方法对23例患者（23只眼）进行了手术。对结果进行了长达3年的随访；眼压得到控制的病例占91.1%，穿透性角膜移植片透明和半透明吸收的占75.6%，62.2%的患者视力从右眼轻度投影提高到0.3屈光度及以上。
