开角型青光眼手术治疗最新进展

摘要

The treatments for open-angle glaucoma include medication, laser and surgery.Trabeculectomy is still the first choice for its efficacy in controlling intraocular pressure. Good nonfiltering bleb surgeries have been developed recently, and the new surgeries include canaloplasty,trabecular bypass devices, the Glaukos iStent trabecular micro-bypass stent, Eyepass glaucoma implant, Gold Micro-Shunt implant, Trabectome, and excimer laser trabeculotomy ab interno. Other new alternatives such as the Ex-PRESS glaucoma shunt and pneumatic rabeculoplasty have also been developed. This article briefly reviews these new techniques.%开角型青光眼的治疗包括药物、激光和手术。小梁切除术因其降低眼压迅速、有效、成功率高，目前仍然是首选的滤过性手术。近年来，新型的治疗开角型青光眼的手术方式有了很大发展，其中以无滤过泡的(非滤过泡依赖的）滤过性手术为主，包括Schlemm管成形术、内引流iStent植入术、外引流Eyepass植入术、前房-脉络膜上腔分流装置Gold Micro-Shunt植入术、内路小梁切开术、内路准分子激光小梁切除术，这些都属于眼内引流手术；其他如Ex-PRESS青光眼微型引流钉植入术和真空小梁成形术等都显示出各自的特点。本综述将对这些最新手术的进展作一简要概述。