RESUMO
Objective To evaluate the therapeutic effects and safety of trabeculectomy combined with Schlemm canal suture implantation in patients POAG). Design Retrospective, noncomparative case series. Participants 11 patients (19 eyes)with POAG. Methods Two layers of scleral flap were made and the deeper one was dissected. The outer wall of Schlemm canal was cut away. 6-0 nylon thread was implanted between the two cut ends of the canal. Penetrating trabeculectomy was performed and followed with peripheral iridectomy. Superficial scleral flap was sutured. Main Outcome Measures The postoperative observation included intraocular pressure (IOP), formation of the anterior chamber, inflammatory reaction, visual acuity, complications and situation of filtering bleb. Results The mean postoperative follow-up period was 18.05?12.78 months (ranging from 6 to 48 months). There was significant statistical difference between preoperative and postoperative IOPs(31.23?9.72mmHg VS 15.11?6.13mmHg) (t=6.769, P=0.000). The postoperative investigation of IOP for 11 cases (19 eyes) after using medicine showed that IOP≥22mmHg only 1 case. The efficiency was 94.74%. Filtering blebs formed in 6 cases (8 eyes)(42.11%), including the case with IOP≥22mmHg. There was no significant difference in change of preoperative and postoperative IOP in patients with or without filtering blebs with t-test (t=-1.662, P=0.071). The anterior chamber formed well in each case postoperatively. Hyphemia appeared in 4 eyes (21.05%). Hypertonia oculi (IOP≥22mmHg) and hypotonia oculi (IOP≤6mmHg) appeared occasionally in 3 eyes(15.78%) and 11 eyes(57.89%) respectively. Postoperatively,no fibrinous exudates in anterior chamber, choroidal detachment and other complications occurred in any case. Conclusions The control of IOP appears to be good after the surgery of trabeculectomy combined with Schlemm canal suture implantation. It is a promising approach for glaucoma and good with fewer postoperative complications, easier postoperative management and deserve further development.