A critical analysis of the trabeculectomy results by a prospective follow-up design.
A critical analysis of the trabeculectomy results by a prospective follow-up design.
复制标题
通过前瞻性随访设计对小梁切除术结果进行批判性分析。
DOI：
--
复制
发表时间：
1982
影响因子：
2.4
通讯作者：
S. Mishima
中科院分区：
文献类型：
--
作者：
S. Shirato;Y. Kitazawa;S. Mishima
对100例113眼原发性开角型青光眼（POAG）、原发性闭角型青光眼（PACG）和继发性青光眼进行了145次小梁切除术。根据预先计划的方案，分析在0.5至3年的随访期间发现的该手术的并发症。浅前房（AC），即AC深度小于手术前深度的一半，在51.7%中发现，平坦AC，即虹膜角膜接触从周边到瞳孔边缘，在15.9%中发现，前房出血在17.9%中发现，脉络膜脱离在33.9%中发现。浅AC通常在几天内消失，仅2.8%的并发症持续一周以上。脉络膜脱离在大多数病例中在3天内消失，仅0.7%的病例需要手术治疗。白内障进展，定义为视力下降超过2行的视力表，被发现在38.6%。脉络膜脱离和白内障进展在浅AC的眼睛中更常见。经简单统计，眼压控制在21 mmHg以下的有效率约为70%。生命表分析表明，首次小梁切除术后POAG的2年成功概率约为57%。在同一只眼睛重复两次手术后，成功率约为37%，但在3次或3次以上重复手术后，一年后成功率仅为10%。
Trabeculectomy was carried out 145 times on 113 eyes of 100 patients, with primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG) or secondary glaucoma. The complications of this surgery found during the follow-up period from 0.5 to 3 years were analyzed according to the preplanned protocol. The shallow anterior chamber (AC), i.e. AC depth being less than half of the depth before surgery, was found in 51.7%, flat AC, i.e. iridocorneal contact from the periphery to the pupillary margin, in 15.9%, hyphema in 17.9% and choroidal detachment in 33.9%. The shallow AC usually disappeared within several days and only in 2.8% was this complication prolonged over one week. The choroidal detachment disappeared within 3 days in most cases, and in only 0.7% was surgical intervention required for its treatment. Progression of cataract, as defined by diminution of the visual acuity more than 2 lines of the acuity chart, was found in 38.6%. The choroidal detachment and cataract progression were significantly more frequent in eyes with the shallow AC. Simple statistics gave a figure of about 70% for the rate of IOP control below 21 mmHg. A life-table analysis gave the 2-year success probability of about 57% in POAG after the first trabeculectomy. After repeating the procedure twice in the same eye, the success probability was about 37%, but after 3 or more repeated operations it was only 10% after one year.