CAJ | 학술논문

目的探讨非穿透性小梁显微手术治疗青光眼的远期疗效.方法对原发性开角型青光眼患者共46例(46眼),随机选择施行非穿透性小梁手术(A组22例,22眼)或穿透性小梁手术(B组24例,24眼),比较两组患者术后的眼压、滤过泡和视野等情况.结果 ①术后观察近50个月,A组眼压有较明显升高的趋势,眼压控制完全成功仅为5眼(22.73%),失败7眼(31.82%);B组完全成功11眼(45.83%),失败4眼(16.67%),但两组的差异无统计学意义(P>0.05);②术后所有B组患者均形成明显的功能性滤过泡;A组患者只有15眼(68.18%)形成明显滤过泡,3眼(13.64%)仅见滤床轻度隆起;随着时间的推移,两组患者滤过泡消失的例数显示出明显差异(P<0.05);③术后50个月的视野改变情况,A组视野缩小者例数为9眼(40.90%),B组为4眼(16.67%),但差异无统计学意义(P=0.068>0.05).结论施行非穿透性小梁手术的部分病例远期疗效欠佳,须谨慎选择适应患者,以提高手术成功率.
목적 탐토비천투성소량현미수술치료청광안적원기료효.방법 대원발성개각형청광안환자공46례(46안),수궤선택시행비천투성소량수술(A조22례,22안)혹천투성소량수술(B조24례,24안),비교량조환자술후적안압、려과포화시야등정황.결과 ①술후관찰근50개월,A조안압유교명현승고적추세,안압공제완전성공부위5안(22.73%),실패7안(31.82%);B조완전성공11안(45.83%),실패4안(16.67%),단량조적차이무통계학의의(P>0.05);②술후소유B조환자균형성명현적공능성려과포;A조환자지유15안(68.18%)형성명현려과포,3안(13.64%)부견려상경도륭기;수착시간적추이,량조환자려과포소실적례수현시출명현차이(P<0.05);③술후50개월적시야개변정황,A조시야축소자례수위9안(40.90%),B조위4안(16.67%),단차이무통계학의의(P=0.068>0.05).결론 시행비천투성소량수술적부분병례원기료효흠가,수근신선택괄응환자,이제고수술성공솔.
Objective To evaluate the long-term clinical effect of non-penetrating trabecular surgery (NPTS)for the treatment of primary open angle glaucoma(POAG). Methods A total of 46 patients(46 eyes) with POAG were observed retrospectively. 22 eyes and 24 eyes uderwent non-penetrating trabecular surgery (NPTS) and trabeculectomy surgery(TS). Intraocular pressure (IOP), filtration bleb and visual field were ob-served. Results ①In the follow-up of 50 month, there was a significant hypertendency in post-operative intraoc-ular pressure in NPTS group. The IOP was controlled successfully in 5 eyes(22. 73%) ,and 7 eyes(31.82%) were failure in NPTS group. 11 eyes(45.83%) were success,4 eyes(16. 67%) were failure in TS group, but there were no statistically significant differences between two groups(P > 0. 05). ②The ratio of sustained filtra-tion bleb of TS group after surgery is 100% ,the ratio of sustained filtration bleb of NPTS group after surgery is 15 (68.18%), while 3 eyes(13.64%)were flat filtrtion hleb. From the time passing by, there were statistically significant differences in the disappearance number of filtration bled between two groups (P < 0. 05). ③After 50 month ,9 eyes (40. 90%) were constriction of fields in NPTS group, while 4 eyes (16. 67%) in TS group, but there were no statistically significant differences between two groups (P = 0. 068 > 0.05). Conclusion Long-term effects of non-penatrating trabecular surgery treating glaucoma were indefinite in some cases. It is very im-portant to choose the suitable surgery to gain high success rate.