The utilized analysis of modified trabeculectomy in advanced stage angle-close glaucoma with cataract / 中国医师进修杂志

ABSTRACT

Objective To compare the feasibility,effectivity and security of modified trabeculectomy in advanced stage angle-close glaucoma with cataract.Methods One hundred and forty-five patients (151 eyes) of advanced stage angle-close glaucoma with cataract were enrolled in this study.Among them,85 patients(91 eyes,observation group) were treated with modified trabeculectomy with the resection of deep scleral resection and 60 patients (60 eyes,control group) were treated with routine trabeculectomy.The visual acuity,intraocular pressure (IOP),type of filtering bleb and postoperative complication were compared.Results There was significant difference in the visual acuity ＜ 0.1,0.4-0.5,＞ 0.5 between after operation for 1 month and before operation in two groups (P ＜ 0.05).but there was no significant difference in the visual acuity 0.1-0.3 (P ＞ 0.05).The IOP before operation in observation group was (29.6 ± 4.1) mmHg (1 mmHg =0.133 kPa),12 months after operation was (13.1 ± 4.9) mmHg,the degree of decrease was (16.6 ± 5.0) mmHg.The IOP before operation in control group was (30.4 ± 6.3) mmHg,12 months after operation was (18.9 ± 3.0) mmHg,the degree of decrease was (10.4 ± 4.0) mmHg.The IOP after operation and the degree of decrease between two groups had significant difference (P ＜ 0.05).The functional filtering bleb(Ⅰ type and Ⅱ type) in observation group was 77 eyes(84.6％,77/91),and 51 eyes(85.0％,51/60) in control group,there was no significant difference (P ＞ 0.05).After operation for 1 month,there was 8 eyes appeared transient hypotony in observation group and 5 eyes in control group,there was no significant difference (P ＞ 0.05).Conclusion The modified trabeculectomy in advanced stage angle-close glaucoma with cataract can reduce IOP more effectively and not increase the intraoperative risk and postoperative complication.