Austin M W, Wishart P K
St Paul's Eye Unit, Royal Liverpool University Hospital, UK.
Ophthalmic Surg. 1993 Jul;24(7):461-6.
Sixteen eyes requiring surgical reformation of the anterior chamber (AC) in our Unit from December 1987 to August 1991 were studied retrospectively to determine the incidence of the problem in our hospital and to evaluate the operative measures used to restore the AC. The mean preoperative AC depth of these 16 eyes was 1.92 mm (range, 1.50 to 2.50 mm). Nine had a history of angle-closure glaucoma. Poor surgical technique was a contributing factor in the development of a flat AC in 3. Of the remaining 13 eyes, 11 had a trabeculectomy with a fornix-based, and 2 with a limbus-based, conjunctival flap. Wound leaks occurred in 10 eyes with fornix-based flaps, but in none of the eyes with limbus-based flaps. Factors associated significantly with the development of flat AC following trabeculectomy were: a preoperative shallow AC, a history of angle-closure glaucoma, and the use of a fornix-based conjunctival flap. Avoiding wound leakage when performing trabeculectomy in eyes with a shallow AC or a history of angle-closure glaucoma by using a limbus-based flap may help prevent postoperative flat AC.
对1987年12月至1991年8月间在我院需行前房（AC）手术重建的16只眼进行回顾性研究，以确定我院该问题的发生率，并评估用于恢复前房的手术措施。这16只眼术前平均前房深度为1.92mm（范围1.50至2.50mm）。9只眼有闭角型青光眼病史。手术技术欠佳是3只眼发生无前房的一个促成因素。其余13只眼中，11只采用了以穹窿为基底的结膜瓣行小梁切除术，2只采用了以角膜缘为基底的结膜瓣。采用以穹窿为基底的结膜瓣的10只眼发生了伤口渗漏，而采用以角膜缘为基底的结膜瓣的眼均未发生。小梁切除术后无前房发生显著相关的因素为：术前前房浅、闭角型青光眼病史以及采用以穹窿为基底的结膜瓣。对于前房浅或有闭角型青光眼病史的眼，在小梁切除术中采用以角膜缘为基底的结膜瓣避免伤口渗漏，可能有助于预防术后无前房。
