SLR技术治疗小梁切除术后晚期滤过泡渗漏的疗效探讨

摘要

目的 探讨SLR (slit-lamp needle revision,SLR)联合结膜下注射5-氟尿嘧啶(5-fluorouracil,5-FU)在治疗滤过泡渗漏中的安全性及疗效.方法 对小梁切除术后2周～4年出现滤过泡渗漏的25例患者(25只眼)行SLR联合5-FU结膜下注射,随访3个月.结果 1.滤过泡:治疗后所有25只眼的滤过泡渗漏立刻缓解,最终治愈23只眼(2次治疗2只眼,3次治疗1只眼),总治愈率为92％.2.眼压:治疗前患者的眼压(8.5±2.1) mmHg,SLR治疗后3个月,眼压(12.5±1.8) mmHg,治疗前后眼压差异有统计学意义(P＜0.05).3.视力:治疗前与治疗后视力比较,差异无统计学意义(P＞0.05).4.并发症:结膜下出血6只眼,前房少许积血2只眼,角膜上皮点状脱落2只眼,眼内炎1只眼.结论 SLR联合5-FU结膜下注射治疗小梁切除术后因为瘢痕所致的滤过泡渗漏是一种有效、安全而且简便的方法.%OBJECTIVE To observe the effect and safety of SLR (slit-lamp needle revision, SLR) technique associated with 5- FU subconjunctival injection on leaking blebs after trabeculectomies. METHODS Twenty-five eyes of 25 patients were undergone SLR associated with 5- FU subconjunctival injection on leaking blebs during 2 weeks to four years after trabeculectomies, and were followed up for three months. RESULTS 1. Blebs:Blebs leakage disappeared immediately after SLR in 25eyes. But belbs leakage reoccurred and were undergone second SLR in 5 eyes, and there were 3 eyes with blebs leakage cured and 2 eyes with bleb repaired after repeat SLR. The rate of cure was 92% 2.IOP; The IOP was(8.5±2.1 )mmHg before SLR and IOP became (12.5±1.8) mmHg 3 months after SLR. There was significant difference between pre-SLR and post-SLR (P<0.05). 3.Visual acuity: there was no significant difference between pre-SLR and post-SLR (P>0.05); 4.Complications: There were 6 eyes with subjunctival hemorrhage,3 eyes with slight hyphaema,2 eyes with dotted epithelial lesions and 1 eye with endophthalmitis. CONCLUSIONS It was safe, effective and simple for SLR associated with 5-FU subconjunctival injection on leaking blebs because of scar after trabeculectomy.