【摘要】 目的 临床评估作者设计的穿透性小梁切除和滤道成形术的安全性和有效性。方法 在穿透性小梁切除术中,于巩膜办下植入一个T形“人工小梁支架”,借助巩膜静脉丛制成一个永存的可吸收房水的间隙。本文选用PMMA制成的人工晶状体的T形袢作支架,为8例志愿者9只绝对期或近绝对期青光眼做了这一手术。观察期5～22个月,平均15.7个月。结果 平均眼压从术前的45.6mmHg降至24.22mmHg。9眼中8眼保持了功能性或部分功能性滤遇泡;2眼视力从持续20多天无光感分别恢复到有光感和0.05。结论 本文提出的穿透性小梁切除和用PMMA制成的T形人工晶体袢作为“人工小梁支架”进行的滤道成形术安全有效,无论对开角和闭角型青光眼,降眼压效果均显著而持久,适应症比传统的非穿透性小梁切除术更广泛,应用前景光明。更多还原

【Abstract】 Objective To evaluate clinically the safety and efficacy of "penetrating trabeculectomy and filtering pathway-plasty" designed by authors. Methods During penetrating trabeculectomy, We implanted and T-shape "artificial trabecular frame" under the scleral flap, and maked a gap absorbing aqueous humor with the help of scleral venous plexus. We chose the T-shape loop of intraocular lens made from PMMA to act as the frame, and performed 9 eyes with absolute or sub-absolute glaucoma of 8 volunteers. Mean followed-up periods were 15.78 months (range 5 to 22 months). Results Mean intraocular pressure decreased from a mean preoperative level of 45.6 mmHg to a mean postoperative level of 24.22 mmHg. In 8 of 9 eyes there were functional or localized functional filtering bleb. Visual acuity of 2 eyes reached 0.05 and light sense respectively while they had no light sense for more than 20 days befroe operation. Conclusion The operation has excellent biocompatibility and encouraging efficacy in both type of glaucoma: close angle and open angle. The penetrating trabeculectomy and filtering pathway plasty could be applied widely more than traditional trabeculectomy and non penetrating trabeculectomy.更多还原