Singh J, Bell R W, Adams A, O'Brien C
Princess Alexandra Eye Pavilion, Royal Infirmary of Edinburgh, Chalmers.
Br J Ophthalmol. 1996 Jul;80(7):624-7. doi: 10.1136/bjo.80.7.624.
To study the efficacy of laser suture lysis in the promotion of filtration and bleb formation during the early postoperative period after trabeculectomy.
This was a prospective study of 20 eyes from 20 patients undergoing trabeculectomy. Patients were entered into the study if, after a trial period of ocular massage, the intraocular pressure (IOP) was greater than 21 mm Hg 48 hours after surgery. Other criteria for inclusion were a deep quiet anterior chamber, no bleb formation, and a patent internal ostium on gonioscopy. Suture lysis was performed using a frequency doubled neodymium YAG (532 nm) laser and a Hoskins lens. The IOP was measured within 5 minutes of lysis and gentle ocular massage was employed if there was no spontaneous bleb formation. A further suture was lysed if at this stage there was still no bleb associated with a high IOP.
Suture lysis was successful in all cases in the early postoperative period. The mean IOP before lysis was 33.8 (SD 8.9) mm Hg and the IOP immediately after lysis was 13.2 (7.9) mm Hg. Eighteen (90%) patients had successfully controlled IOP (mean 14.1 (3.6) mm Hg) without medication after a mean follow up of 6 months.
Laser suture lysis is a safe and effective method of promoting filtration following trabeculectomy. It can avoid surgical manipulation of the scleral flap with its associated risks of bleb failure and thereby contributes to a successful operative outcome.
研究激光缝线松解术在小梁切除术后早期促进滤过和滤泡形成的疗效。
这是一项对20例接受小梁切除术的患者的20只眼睛进行的前瞻性研究。如果在进行眼部按摩的试验期后，术后48小时眼压（IOP）大于21 mmHg，则将患者纳入研究。其他纳入标准包括前房深且安静、无滤泡形成以及房角镜检查显示内口通畅。使用倍频钕钇铝石榴石（532 nm）激光和霍斯金斯透镜进行缝线松解。在松解后5分钟内测量眼压，如果没有自发滤泡形成，则进行轻柔的眼部按摩。如果在此阶段仍没有与高眼压相关的滤泡，则进一步松解一根缝线。
术后早期所有病例的缝线松解均成功。松解前平均眼压为33.8（标准差8.9）mmHg，松解后立即眼压为13.2（7.9）mmHg。平均随访6个月后，18例（90%）患者无需药物治疗眼压得到成功控制（平均14.1（3.6）mmHg）。
激光缝线松解术是小梁切除术后促进滤过的一种安全有效的方法。它可以避免对巩膜瓣进行手术操作及其相关的滤泡失败风险，从而有助于手术成功。
