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目的探讨抗青光眼术后眼压不降的原因,观察复合小梁切除术治疗抗青光眼术后眼压不降的临床效果,分析复合小梁切除术在治疗抗青光眼术后眼压不降再次手术中的重要作用。方法对22例22眼抗青光眼术后眼压不降患者再次接受复合小梁切除术治疗的患者进行回顾性分析。其中第1次抗青光眼手术中:虹膜周边切除术有6例,激光虹膜周切术3例,小梁切除术13例。结果 22例患者术前眼压19～66mmHg,术后眼压水平6～14mmHg。手术后眼压下降率41%～80%不等,平均下降率59.8%。术后视力能够提高一行或者以上的有6例,基本维持不变的有7例,下降一行的有5例,下降两行或以上的有4例。结论复合小梁切除术可以作为抗青光眼失败后再次行滤过手术时的一个很好选择,它具有安全、有效、可重复的特性,值得在临床工作中广泛推广。
Objective To investigate the causes of non-drop of intraocular pressure (IOP) after anti-glaucoma surgery and to observe the clinical effect of compound trabeculectomy in preventing the intraocular pressure from lowering after glaucoma surgery. To analyze the effect of compound trabeculectomy In the important role. Methods A retrospective analysis was performed on 22 patients who underwent combined trabeculectomy in 22 eyes with glaucoma who had undergone intraocular pressure (IOP) reduction. The first anti-glaucoma surgery: iris peripheral resection in 6 cases, laser iridectomy in 3 cases, trabeculectomy in 13 cases. Results Twenty-two patients had preoperative IOP 19 ~ 66mmHg and postoperative IOP 6 ~ 14mmHg. The intraocular pressure after surgery decreased from 41% to 80%, the average rate of decline of 59.8%. Postoperative visual acuity can improve one or more of the 6 cases, the basic remained unchanged in 7 cases, down a line in 5 cases, down two lines or more in 4 cases. Conclusion Composite trabeculectomy can be used as a good alternative to glaucoma after failed filtration surgery. It is safe, effective and repeatable, which is worth to be popularized widely in clinical practice.