【摘要】  　　目的：探讨前房穿刺在管状视野青光眼滤过手术中避免发生并发症的有效性。方法：42例（42眼）管状视野青光眼患者在表面麻醉下行滤过手术，术中通过前房穿刺缓慢放出房水，防止视力丧失，术后5～7d复查视野、眼压。 结果：42例手术无1例丧失残存视功能，视力维持术前或有所提高，视野有改善，眼压控制良好。结论：本研究证实采用前房穿刺技术在管状视野青光眼滤过手术中对于避免出现视力丧失是一种安全有效的方法。

【关键词】  前房穿刺　管状视野　青光眼　滤过手术

　　Paracentesis in trabeculectomy for glaucoma with tubular visual fields

    Xiao-Yun Dong, Xiao-Wei Gao, Rui-Fu Wang, Xiao-Yu Gu

    Department of Ophthalmology, No. 474 Hospital of Chinese PLA, Urumchi 830011, Sinkiang Autonomous Region, China

    Correspondence to: Xiao-Yun Dong. Department of Ophthalmology, No. 474 Hospital of Chinese PLA, Urumchi 830011, Sinkiang Autonomous Region, China, [email protected]

    Received：2006-08-22 Accepted：2006-10-13

    Abstract AIM: To evaluate the clinical effects of paracentesis of anterior chamber in trabeculectomy for advanced glaucoma with tubular visual fields to avoid complications.· METHODS: Forty-two patients (42 eyes) of advanced glaucoma with tubular visual fields underwent trabeculectomy under topical anesthesia, during which the aqueous fluid was drained gradually through anterior chamber to avoid the loss of vision. Visual field and intraocular pressure were re-examined at postoperative 5 to 7 days. RESULTS: There was no loss of remnant visual function in any of the 42 cases. After operation, visual acuity and visual fields improved or remained unchanged, and the intraocular pressure was kept steadily. CONCLUSION: Paracentesis of anterior chamber during trabeculectomy is proved to be safe and reliable to avoid the loss of vision in treating advanced glaucoma with tubular visual fields.

    · KEYWORDS: paracentesis of anterior chamber; tubular visual fields; glaucoma; trabeculectomy

　　0引言

    近年来由于白内障复明手术的普遍开展，传染性角膜疾病的有效控制，导致青光眼的致盲率相对提高。急性闭角型青光眼随着医疗水平、青光眼检查设备的发展而得到及时有效的控制，但是有一些起病隐匿发展缓慢的原发性青光眼由于漏诊、误诊或患者的疏忽发展成管状视野，视功能严重受损时才来就诊，增加了治疗的风险性。我们采用了前房穿刺联合小梁切除术对管状视野青光眼进行手术治疗，取得良好疗效，现报道如下。

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