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小梁切除术滤泡相关的感染性疾病

Razeghinejad MR, Havens SJ, Katz LJ

期刊名称:Survey of Ophthalmology

卷期:2017年第62卷第5期

摘要

摘要:抗代谢药物加小梁切除术是世界上最常用的治疗尽管经最大量的降眼压药物治疗,但仍有进行性视神经损伤和视野丧失的青光眼患者的手术方式。因为其预后不良和对抗微生物治疗的反应不一,小梁切除术滤泡相关感染仍然是小梁切除术手术最可怕的早期和长期并发症之一。几项研究已经对手术技术,结膜切口位置,共病眼病理,同时使用的药物和泡状形态如何影响滤泡相关感染风险进行了评估。新的手术技术和装置旨在实现与小梁切除术相似的降眼压,同时避免出现结膜滤泡。我们对评估小梁切除术后滤泡相关感染危险因素的研究进行了综述,并提出了一种诊断和治疗滤泡相关感染的方法。

Trabeculectomy with antimetabolites is the most commonly performed surgery worldwide for glaucoma patients with progressive optic nerve head injury and visual field loss despite maximum pharmacologic intraocular pressure-lowering therapy. Trabeculectomy bleb-associated infections remain one of the most feared early and long-term complications of trabeculectomy surgery because of their poor prognosis and variable response to antimicrobial therapy. Several studies have evaluated how surgical technique, conjunctival incision location, comorbid ocular pathology, concurrent medication use, and bleb morphology affect the risk of bleb-associated infection. New surgical techniques and devices aim to achieve a similar intraocular pressure reduction profile to trabeculectomy while avoiding the presence of a conjunctival bleb. We provide a comprehensive review of studies evaluating risk factors for bleb-associated infection after trabeculectomy and propose a diagnostic and therapeutic approach to bleb-associated infection.

PMID28188728


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