Khalil DH, Abdelhakim MA
小梁 切除术 切开术
目的：旨在比较原发性小梁切除术与丝裂霉素C（MMC）联合小梁切开术 - 小梁切除术（CTT）治疗先天性青光眼患儿的预后。方法：这是一项前瞻性的比较研究，包括28只（28例婴儿）先天性青光眼。将根据眼内压（IOP），杯/盘比（C / D比），角膜直径和轴向长度测量结果确诊的先天性青光眼婴儿随机分配至A组（小梁切开术）或B组（CTT联合MMC）。术后，所有患者均定期随访3年;用于IOP和C / D评估。成功预后标准包括角膜水肿消退，盘杯比倒置和IOP 18mmHg以下。结果：每组成功率为85.7％（p = 1.00）。两组的所有术前参数，包括水平角膜直径，轴向长度，IOP和C / D比之间没有统计学显着差异。此外，在不同的随访中，术后C / D比，IOP，IOP差异和百分比差异（与术前值相比）上，两种手术技术之间没有统计学显着差异。每组术前与术后IOP和C / D比值差异比较有统计学意义。结论：原发性小梁切除术和CTM与MMC联合治疗的预后类似，这可能意味着小梁切除术可以首先使用。
PURPOSE:To compare the outcome of primary trabeculotomy with that of combined trabeculectomy-trabeculotomy (CTT) with mitomycin C (MMC) in children with congenital glaucoma.METHODS:This is a prospective comparative study, carried out on a cohort of 28 eyes (28 infants) with congenital glaucoma. Infants with proved congenital glaucoma [based on intra-ocular pressure (IOP), cup/disc (C/D ratio), corneal diameter and axial length measurements] were randomly allocated to either group A (trabeculotomy) or group B (CTT with MMC). Postoperatively, all patients were followed regularly for 3years; for IOP and C/D evaluation. Criteria for successful outcome included resolution of corneal oedema, reversal of disc cupping, and IOP 18mmHg or less.RESULTS:Success rate in each group was 85.7% (p=1.00). All preoperative parameters, including horizontal corneal diameter, axial length, IOP and C/D ratio, were not statistically significantly different between the two groups. Also, postoperative C/D ratio, IOP, IOP difference and percentage difference (compared to preoperative values), at different follow-up visits, were not statistically significantly different between both surgical techniques. Comparing preoperative to postoperative IOP and C/D ratio in each group was statistically significant.CONCLUSION:Both primary trabeculotomy and CTT with MMC had similar outcomes, which could mean that trabeculotomy could be resorted to first.