Batterbury M, Wishart P K
St. Paul's Eye Unit, Royal Liverpool University Hospital, UK.
Eye (Lond). 1993;7 ( Pt 1):109-12. doi: 10.1038/eye.1993.23.
A modification of the trabeculectomy technique was designed in an attempt to increase the outflow of aqueous into the subconjunctival space in the early post-operative period. This 'high flow' method was compared with a control group of eyes undergoing a standard trabeculectomy. Fifty-three eyes of 44 patients were recruited to this study. Follow-up was for a minimum of 12 months (mean 20 months). The high flow method resulted in lower intraocular pressures (IOP) on days 1 and 2 and shallower anterior chambers without increased incidence of conjunctival wound leak, suggesting that high outflow was indeed achieved. However, long-term control of IOP was not better than that achieved by the conventional technique. IOP control (IOP < 21 mmHg) was achieved in 64.2% of eyes (34 eyes) without additional topical medication. IOP control with topical medication was satisfactory in the remaining 19 eyes, and no patient required further drainage surgery. Further analysis of the data showed that the most important factor determining success or failure of trabeculectomy in controlling IOP was the duration and number of prior topical medications. The success rate for trabeculectomy was significantly higher in those eyes with a shorter duration and quantity of prior topical therapy.
为了在术后早期增加房水向结膜下间隙的流出量，设计了一种小梁切除术技术的改良方法。将这种“高流量”方法与接受标准小梁切除术的对照组眼睛进行了比较。44例患者的53只眼睛被纳入本研究。随访时间至少为12个月（平均20个月）。高流量方法在第1天和第2天导致眼压（IOP）降低，前房变浅，且结膜伤口渗漏的发生率没有增加，这表明确实实现了高流出量。然而，眼压的长期控制并不比传统技术更好。在未使用额外局部药物的情况下，64.2%的眼睛（34只）实现了眼压控制（眼压<21 mmHg）。其余19只眼睛使用局部药物控制眼压效果良好，没有患者需要进一步的引流手术。对数据的进一步分析表明，决定小梁切除术控制眼压成败的最重要因素是先前局部用药的持续时间和次数。在先前局部治疗持续时间较短且用药量较少的眼睛中，小梁切除术的成功率显著更高。
