【摘要】 目的 观察管状视野的晚期青光眼患者术后视野与术后眼压的关系。方法 我们对收治的32 例(44 眼)患者根据不同的术后眼压值分为3 组，A组：15 眼，眼压高于18 mmHg;B组：15 眼，眼压介于18～12 mmHg之间;C组：14 眼，眼压介于12～5 mmHg之内。比较三组受试者的视力、MD值及术后满意度。结果 A组患者手术前后视野平均缺损(MD)仍有下降，差异有显著性意义，说明术后眼压在18 mmHg以上视野仍会继续缺失。B组中患者手术前后视野平均缺损(MD)有所提升，但无显著性意义，说明降低眼压对部分青光眼患者可以减缓视野的恶化和青光眼进展。C组中患者手术前后视野平均缺损(MD)有明显回升，且差异有显著性意义，说明术后将眼压控制在12～5 mmHg之内对改善晚期青光眼患者术后视野有明显作用。结论 晚期青光眼患者最好将眼压控制在12～5 mmHg之内，对晚期青光眼患者的视野变化有指导性作用。

　　【关键词】 青光眼;管状视野;MD

　　2.Department of Ophthalmology，the Second Affiliated Hospital of Jilin University, Changchun 130000 China)Abstract：Objectives To observe the relation of postoperation visual field and postoperation IOP of advanced glaucoma with tubular visual field. Methods 32 patients (44 eyes) were divided into three groups by postoperation IOP. Group A: 15 eyes, postoperation IOPgt;18 mmHg，group B: 15 eyes, postoperation IOP is between 18 mmHg and 12 mmHg,group C: 14 eyes, postoperation IOP is between 12 mmHg and 5 mmHg. The vision, MD and postoperative satisfaction among three groups of subjects were compared. Results Group A: the MD of postoperation descend, and the discrepancy is statistically significant, which means visual field is still decreasing even if postoperation IOP gt;18 mmHg，group B: the MD of postoperation is lightly promoting, and the discrepancy is not statistically significant, which means the depression of postoperation IOP is partly helpful to the aggravation of visual field and development of advanced glaucoma，group C: the MD of postoperation is obviously promoting, and the discrepancy is statistically significant, which means controlling the postoperation IOP within 12～5 mmHg can obviously promote the visual field of advanced glaucoma. Conclusions We should control the postoperation IOP of advanced glaucoma within 12～5 mmHg, and testing visual field regularly is instructive to monitoring the variation of visual field of advanced glaucoma.

　　Key words: glaucoma; tubular visual field; MD

　　青光眼是以特征性视神经萎缩及视野损害为共同特征的不可逆性致盲眼病，2003年第四届国际青光眼大会提出，全球大约有6 700 万青光眼患者，致盲率已居世界致盲眼病的第二位[1,2]。青光眼导致视功能损害的病理基础是视网膜神经节细胞(retinal ganglion cells, RGCs) 进行性死亡和视神经纤维丧失。RGCs 的死亡常导致视功能发生不可逆性损害。目前普遍认为晚期青光眼患者术后眼压降的越低越好，但对于具体应该控制在什么范围内对视野的恢复有帮助并无确切的标准。许多青光眼患者即使眼压已降至正常范围，但视野仍不断缺损，视神经损害仍在加重。视野检查对青光眼的诊断、病情的观察及术后病情评估有极其重要的作用[3]。本研究对2002年1月至2006年12月于我院眼科病房行抗青光眼手术的32 例(44 眼)管状视野结果加以追踪分析，以期对临床晚期青光眼患者术后眼压控制范围提供一些依据。

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