Cioffi G A, Van Buskirk E M
Devers Eye Institute, Good Samaritan Hospital and Medical Center, Portland, Oregon 97210.
Ophthalmology. 1993 Jul;100(7):1077-82. doi: 10.1016/s0161-6420(93)31535-6.
Corneal trabeculectomy, a guarded filtration procedure without conjunctival incision but with an iridectomy, was developed in 30 eyebank and 20 rabbit eyes before being applied to humans.
Corneal trabeculectomy was performed in one eye and conventional trabeculectomy in the contralateral eyes of six rabbits. Sequential postoperative histologic examinations were performed on these eyes at various times after surgery. Corneal trabeculectomy also was performed in 20 eyes of 18 patients with glaucoma for control of their intraocular pressure (IOP).
Results of histologic examination on these rabbit eyes showed less subconjunctival inflammation and fibrosis after corneal trabeculectomy than conventional trabeculectomy. In the eight patients with glaucoma who had had their surgery at least 1 year previously, the mean IOP decreased from 31 mmHg (preoperatively) to 14 mmHg. Eighty-eight percent have IOPs less than or equal to 18 mmHg without medications or revision.
Extended follow-up shows that corneal trabeculectomy is a low-tech, relatively atraumatic filtration procedure without conjunctival incision, which produces diffuse and persistent blebs and controls IOP. Results of sequential postoperative histologic examination in rabbit eyes suggest that corneal trabeculectomy may incite less subconjunctival inflammation than conventional trabeculectomy.
角膜小梁切除术是一种不做结膜切口但需行虹膜切除术的保护性滤过手术，在应用于人类之前，先在30只供体眼和20只兔眼上进行了研究。
对6只兔子的一只眼行角膜小梁切除术，对侧眼行传统小梁切除术。术后在不同时间对这些眼睛进行连续的组织学检查。还对18例青光眼患者的20只眼睛进行了角膜小梁切除术以控制眼压。
这些兔眼的组织学检查结果显示，角膜小梁切除术后结膜下炎症和纤维化比传统小梁切除术少。在至少1年前接受手术的8例青光眼患者中，平均眼压从术前的31 mmHg降至14 mmHg。88%的患者在未用药或未进行手术修正的情况下眼压小于或等于18 mmHg。
长期随访表明，角膜小梁切除术是一种技术要求低、相对无创的无结膜切口滤过手术，可产生弥散性和持久性的滤过泡并控制眼压。兔眼术后连续组织学检查结果提示，角膜小梁切除术可能比传统小梁切除术引起的结膜下炎症更少。
