소절개창 섬유주절제술에 대한 임상연구

We analysed the clinical results of small incision trabeculectomy performed on 5 eyes with open angle glaucoma, 5 eyes with angle closure glaucoma, 3 eyes with angle recession glaucoma, 4 eyes with secondary glaucoma, 5 eyes with juvenile glaucoma,1 eye with combined mechanism glaucoma, 12 eyes with neovascular glaucoma and 2 eyes with aphakic glaucoma.Small incision trabeculectomy was performed on 33 eyes with glaucoma and triple operation was performed on 4 eyes with coexisting cataract and glaucoma. This study was focused on change of intraocular pressure, visual acuity, number of antiglaucomatous drug,appearance of bleb,corneal astigmatism,postopera-tive complications. Average follow-up period was 42.4 weeks(12~102 weeks). The mean intraocular pressure of the small incision trabeculectomy was reduced from 39.1 ±16.2 mmHg preoperatively to 13.0 ±6.0 mmHg(p＜0.05) at last follow up. The mean visual acuity with Han's visual acuity chartimproved from 0.3±0.3 preoperative to 0.5±0.4 (p＜0.05) at last follow up. The mean number of antiglaucomatous drugs was also significantly reduced from 3.7±1.7 preoperatively to 0.4±0.4(p＜0.05) at last follow up. The mean IOP of the triple operation was reduced from 28.3±5.3 mmHg preoperatively to 14.5±3.5 mmHg at last follow up. The mean visual acuity with Han's visual acuity chart improved from 0.2±0.3 preoperatively to 0.3±0.2 at last follow up. The mean number of antiglaucomatous drugs was reduced from 2.3±0.5 preoperatively to 0.5±0.3 at last follow up. The preoperative mean astigmatism was 1.7±2.3 D, postoperative mean astigmatism was 5.2±2.5 D at postoperative 1st week and significantly decreased to 1.4±1.1 D(p＜0.05) in all patients at last follow up. The postop-erative complications included hypotony in 2 eyes, conjunctival wound leak-ing in 5 eyes, shallow anterior chamber in 3 eyes and high IOP in 7 eyes. Diffuse low lying, avascular blebs were observed in postoperative period and IOP's were well controlled with or without antiglaucomatous eye drops. Small incision trabeculectomy with or without cataract operation may be a safe and effective filtering surgery in controlling IOP with minimum compli-cations and can be used as the first choice procedure in glaucoma surgery(J Korean Ophthalmol Soc 41:2603~2610,2000).