Short-Term Intraocular Pressure Dynamics after Trabeculectomy

小樑網切除術後短期眼內壓之變化

李世煌(Shi-Huang Lee) ； 吳澄舜(Cheng-Shun Wu)

《中華民國眼科醫學會雜誌》 38卷4期 (1999/12) Pp. 592-598

https://doi.org/10.30048/ACTASOS.199912.0003

摘要

為了解青光眼手術後，早期眼內壓的高低對小樑網切除術成功率之影響，我們收集過去三年內曾於本院接受單純小樑網切除術的患者；經去除手術後有嚴重併發症，且需再做進一步手術之患者，我們共收集得228位患者。手術後三個月，如有濾泡形成且眼壓不需藥物即能維持在5~22mmHg之間，我們定義為成功。全部228位患者，術後三個月手術成功之比率為66.2%；手術後之平均眼壓以第一天為最低(3.62mmHg)，其後逐漸上升，第二週為10.46mmHg，一個月為11.69mmHg，三個月為13.21mmHg。手術後兩週內如眼壓低於12mmHg，則術三個月之成功率為69.7%；反之，如術後兩週眼壓已大於12mmHg，則手術之成功率只有43.8%。由以上之發現，我們認為青光眼手術後早期眼壓最好維持在12mmHg以下，如術後兩週內發現眼壓超過12mmHg，便應考慮做縫線拆除或眼球按摩，以期增進手術之成功率。

並列摘要

To determine the influence of early postoperative intraocular pressure on final outcome of trabeculectomy, we retrospectively reviewed 228 patients who had received trabeculectomy between January 1994 and June 1997. Patients who had complications requiring surgical intervention were excluded. Three months after the operation, the presence of a cystic filtering bleb plus an IOP of 5~22mmHg without any medication was defined as success. The total successful rate was 66.2%. Mean postoperative IOP was 3.62mmHg at day 1, 10.46mmHg at day 14, 11.69mmHg at 1 month, and 13.21mmHg at 3 months. Intraocular pressure at 2nd week had significant influence on final outcome: the final successful rate of patients with an IOP＜12 mmHg at 2nd week was significantly higher than those with an IOP≥12mmHg (69.7% Vs 43.8%). An IOP of ≥12mmHg at 2nd week after trabeculectomy may be an indication for suture lysis or digital massage.

並列關鍵字

Glaucoma ； Trabeculectomy ； Intraocular pressure