Objective To explore the effect of complex trabeculectomy for glaucoma patients with thin Tenon's capsule.Methods 63 primary glaucoma patients (63 eyes) with thin Tenon's capsule treated in Affiliated Hospital of Chengde Medical College from August 2014 to August 2016 were enrolled retrospectively in the study.All patients accepted trabeculectomy with intraoperative appropriate application of Mitomycin.All patients were observed closely after surgery and accepted early needle suture cut if necessary.The early postoperative anterior chamber formation,filtering bleb and intraocular pressure were observed.The long-term effect of 6 months of follow-up was observed.Results Postoperative 1 month,60 cases (95.24％) were successful,including 31 cases (93.94％) with Mitomycin,29 cases (96.67％) without Mitomycin,the difference was not statistically significant (P ＞ 0.05).Type Ⅰ filtering blebs were observed in 7 cases (21.21％) with Mitomycin,and 1 case (3.33％) without Mitomycin,the difference was statistically significant (P ＜ 0.05).Postoperative 6 months,52 cases (82.54％) were successful,including 30 cases (90.91％) with Mitomycin,22 cases (73.33％) without Mitomycin,the difference was statistically significant (P ＜ 0.05).Type Ⅰ filtering blebs were observed in 10 cases (30.3％) with Mitomycin,and 2 case (6.67％) without Mitomycin,the difference was statistically significant (P ＜ 0.05).The mean intraocular pressure at 1 week,1 month and 6 months after operation was (12.63±2.29),(13.69±2.43),(15.33± 1.88) mmHg,respectively,those were significantly decreased than that before operation,the differences were statistically significant (P ＜ 0.05).Conclusion Complex trabeculectomy is effective for primary glaucoma with thin Tenon's capsule,early needle suture cut after operation for primary glaucoma with thin Tenon's capsule is simple and effective.It is worthy of promotion and application in primary hospitals.%目的 探讨复合式小梁切除术对薄Tenon囊青光眼患者的疗效.方法 回顾性分析2014年8月～2016年8月承德医学院附属医院诊治的63例(63眼)Tenon囊薄的原发性青光眼患者,行小梁切除手术,术中酌情应用丝裂霉素,术后密切观察,必要时早期针拨断线,观察术后早期前房形成、滤过泡、眼压情况,及随访6个月的远期疗效.结果 术后1个月,成功60例(95.24％),其中应用丝裂霉素者31例(93.94％),未应用丝裂霉素者29例(96.67％),二者比较差异无统计学意义(P＞0.05);形成Ⅰ型滤过泡患者中应用丝裂霉素者7例(21.21％),未应用丝裂霉素者1例(3.33％),二者比较差异有统计学意义(P＜0.05).术后6个月,成功52例(82.54％),其中应用丝裂霉素者30例(90.91％),未应用丝裂霉素者22例(73.33％),二者比较差异有统计学意义(P＜0.05);形成Ⅰ型滤过泡患者中应用丝裂霉素者10例(30.3％),未应用丝裂霉素者2例(6.67％),二者比较差异有统计学意义(P＜0.05).术后1周、术后1个月、术后6个月患者平均眼压分别为(12.63±2.29)、(13.69±2.43)、(15.33±1.88)mmHg,与治疗前比较显著降低,差异有统计学意义(P＜0.05).结论 复合式小梁切除术治疗薄Tenon囊的原发性青光眼效果好.Tenon囊薄者小梁切除术后早期针拨断线,简单手术效果好,值得基层医院推广应用.
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