Smith M F, Doyle J W
Department of Ophthalmology, University of Florida School of Medicine, Gainesville, USA.
Ophthalmic Surg Lasers. 1996 Jun;27(6):417-21.
Initial overdrainage following filtration surgery can be frustrating to manage. The authors reviewed the records of 10 patients with early postoperative hypotony following filtration surgery who were treated with application of an oversized 17.0-mm bandage soft contact lens (BSCL).
Nine eyes had undergone trabeculectomy with either mitomycin-C or 5-fluorouracil intraoperative application, and one eye had undergone tenonectomy 4 years following trabeculectomy. On postoperative day 1, seven eyes were hypotonous, and three other eyes became hypotonous following suture removal or lysis. An oversized 17.0-mm BSCL was placed immediately following the diagnosis of hypotony on all eyes except one, which had the BSCL applied after 24 hours of observation.
In 9 of 10 cases intraocular pressure rose 5 to 12 mm Hg following placement of the BSCL. During a 6- to 18-months follow-up, all successfully treated eyes had final intraocular pressures of 5 to 11 mm Hg, with extensive low to moderate height blebs.
Oversized BSCLs can be a useful tool in the management of early hypotony following filtration surgery.
滤过性手术后初期过度引流难以处理。作者回顾了10例滤过性手术后早期低眼压患者的病历，这些患者接受了佩戴17.0毫米超大号绷带软性角膜接触镜（BSCL）的治疗。
9只眼接受了术中应用丝裂霉素C或5-氟尿嘧啶的小梁切除术，1只眼在小梁切除术后4年接受了眼球筋膜切除术。术后第1天，7只眼为低眼压，另外3只眼在拆线或缝线溶解后出现低眼压。除1只眼在观察24小时后佩戴BSCL外，其余所有眼在诊断为低眼压后立即佩戴17.0毫米超大号BSCL。
10例中有9例在佩戴BSCL后眼压升高了5至12毫米汞柱。在6至18个月的随访期间，所有成功治疗的眼最终眼压为5至11毫米汞柱，伴有广泛的低至中等高度的滤过泡。
超大号BSCL可作为处理滤过性手术后早期低眼压的有用工具。
