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目的观察针分离术联合曲安奈德治疗小梁切除术后瘢痕性无功能滤过泡的疗效。方法对16例(20眼)常规小梁切除术后瘢痕性无功能滤过泡、眼压失控患者行再次手术,手术方式为针分离术联合球结膜下注射曲安奈德。术前和术后1、2、8、15 d及1、2、3、6、9个月,以后每3个月进行视力、眼压、裂隙灯显微镜检查及检眼镜、超声生物显微镜(UBM)、海德堡视网膜断层扫描(HRT-2)、视野等检查。结果术前眼压(37.52±6.41)mm Hg,术后第1天(10.23±3.15)mmHg,经3～9个月随访,最后随访(14.51±3.20)mm Hg,仅2眼再一次出现眼压失控行抗青光眼联合手术。其他患眼均没有出现术后浅前房、炎症反应等并发症。结论针分离术联合曲安奈德治疗小梁切除术后瘢痕性无功能滤过泡的手术成功率高,安全、简便,且并发症少,值得临床上推广应用。
Objective To observe the effect of needle separation combined with triamcinolone acetonide on cicatricial nonfunctioning filtration bleb after trabeculectomy. Methods Reoperation was performed in 16 patients (20 eyes) with traumatic nonfunctional cataract and non-functional cataract after trabeculectomy. The operation mode was needle dissection combined with subconjunctival injection of triamcinolone acetonide. Visual acuity, intraocular pressure, slit lamp microscopy and ophthalmoscope, and ultrasound biomicroscopy (UBM) were performed before surgery and at 1, 2, 8, 15 and 1, 2, 3, 6 and 9 months after surgery. ), Heidelberg Retina Tomography (HRT-2), visual field and other tests. Results The preoperative intraocular pressure (37.52 ± 6.41) mm Hg and the first postoperative day (10.23 ± 3.15) mmHg were followed up for 3 to 9 months and followed up for (14.51 ± 3.20) mm Hg, with only 2 eyes again Loss of control line anti-glaucoma surgery. No other postoperative patients with shallow anterior chamber anterior chamber, inflammatory response and other complications. Conclusions The successful operation of needle separation combined with triamcinolone acetonide in the treatment of cicatricial nonfunctioning filtration bleb after trabeculectomy is safe, simple and has few complications. It is worth to be popularized clinically.