Outcomes of Trabeculectomy Versus Trabeculectomy Combined with Deep Sclerectomy in Glaucoma Patients: 15-Month Follow-Up (A Preliminary Report)

青光眼患者施行小樑切除術或合併深層鞏膜切除術後－十五個月追蹤結果

徐敏文(Min-Wen Hsu) ； 徐旭亮(Shiuh-Liang Hsu) ； 吳國揚(Kwou-Yeung Wu)

《中華民國眼科醫學會雜誌》 45卷4期 (2006/12) Pp. 383-389

https://doi.org/10.30048/ACTASOS.200612.0005

摘要

目的：比較青光眼患昔施行小樑切除術及小樑切除術合併深層鞏膜切除術之術後效果
方法：自1995年7月至2001年7月共有37位年齡大於40歲原發性青光眼患者共49顆眼睛納入研究。28顆眼睛接受制式青光眼小樑切除術(group T)，21顆眼睛接受小樑切除術合併深層鞏膜切除術(group TS)，所有49顆眼睛皆接受經角膜可拆式縫線法以防止術後前房消失及眼壓過低。術中並未使用mitomycin-C。手術成功定義為術後眼壓小於21mmHg且未使用降眼壓藥物。本研究記錄並比較兩組術後的眼壓變化、併發症及手術成功率。
結果：所有的患者皆追蹤15個月。在group T，最終平均眼壓為15.6±3.76mmHg，有四顆眼睛未達手術成功，成功率為85.71%。在group TS，最終平均眼壓為13.8±3.87mmHg，手術成功率為百分之百。兩種手術的成功率在統計學上並未有顯著之差別，然而，我們發現在小樑切除術合併深層鞏膜切除術這一組似乎可得到較好的眼壓控制，至於更長時間追蹤後會不會呈有意義之差別，則有待觀察。
結論：兩種手術方式在我們的追蹤期間皆可有效的控制青光眼患者的眼壓。

並列摘要

Purpose: To compare surgical efficiencies of tracbeculectomy versus trabeculectomy combined with deep sclerectomy in glaucoma patients.
Methods: From July 1995 to July 2001, 49 eyes of 37 primary glaucoma patients (age＞40 years old) were enrolled in this study. Twenty-eight eyes received trabeculectomy (group T), and 21 eyes received trabeculectomy combined with deep sclerectomy (group TS). The transcorneal releasable suture method was performed on all 49 eyes. No intraoperative mitomycin-C (MMC) application was used for patients in this study. Complete surgical success was defined as a postoperative intraocular pressure (IOP) lower than 21 mm Hg, without any antiglaucoma medication. Any postoperative lop complication as well as the success rate was recorded and compared.
Results: The follow-up period for all patients was 15 months. In group T, the final mean IOP was 15.6±3.76 mm Hg. Four eyes failed to achieve surgical success. In group TS, the final mean IOP was 13.8±3.87 mm Hg. Surgical success rate was 100%. In spite of no significant difference between the success rates of these two surgical methods, it appeared that IOP was better controlled in the group TS.
Conclusions: Both techniques, trabeculectomy and trabeculectomy combined with deep sclerectomy, controlled IOP efficaciously at our endpoint, in primary glaucoma patients.

並列關鍵字

deep sclerectomy ； internal drainage ； trabeculectomy