Objective:To explore the clinical effect of early laser disconnection and needle disconnec-tion for intraocular pressure control after trabeculectomy. Methods:Fifty primary glaucoma patients (50 eyes) were enrolled in the study from August 2014 to February 2017 in the affiliated hospital of Chengde Medical College. All patients accepted complex trabeculectomy. All patients were observed closely after surgery and ac-cepted early needle or laser suture cut if necessary. Subjective symptoms, vision, intraocular pressure and an-terior chamber were observed to compare effect of these two disconnection methods for intraocular pressure con-trol after glaucoma surgery. Results: Within one month after surgery, 18 cases accepted laser disconnection ( laser group) , 19 cases accepted needle disconnection ( needle group) . To the end of follow-up, 38 cases of all(76%) were successful , 12 cases (24%) were effective. 14 cases (77.78%) in the laser group were suc-cessful, 15 cases (78.95%) in needle group were successful, there was no significant difference in the suc-cess rate between the two groups (P>0.05).There was no significant difference in scores of subjective symp-toms between the two groups before disconnection ( P>0. 05 ) . The scores of subjective symptoms in layser group was significantly lower than that in needle group at 1 day after disconnection ,the difference was statisti-cally significant ( P <0.05) . There was no significant difference in scores of subjective symptoms between the two groups at 3days and7days (P>0.05).There was no significant difference in best corrected visual acuity and anterior chamber depth in the two groups at 1 week after disconnection compared with before disconnection ( P>0.05) . There was significant difference in intraocular pressure at 1 week after disconnection and the last fol-low-up compared with before disconnection(P<0.05). Conclusion: Complex trabeculectomy combined withearly laser or needle disconnection is safe and effective. Clinicians can choose it appropriately according to hos-pital and patient conditions.%目的:探讨小梁切除术后早期激光断线和针拨断线控制眼压的临床效果.方法:选取2014年8月至2017年2月50例(50只眼)原发性青光眼患者,行复合式小梁切除手术,术后密切观察,必要时早期采用激光或针拨的方法切断巩膜缝线,观察患者眼部主觉症状、视力、眼压及前房情况,比较这两种断线方法在青光眼术后控制眼压的疗效.结果:术后1个月内,采用激光断线18例(激光组),针拨断线19例(针拨组).至随访结束,共成功38例(76%),有效12例(24%);断线的患者中,激光组成功14例(77.78%),针拨组成功15例(78.95%),两组患者手术成功率比较差异无统计学意义(P>0.05).断线前激光组与针拨组主觉症状评分比较差异无统计学意义(P>0.05);断线后1d,激光组主觉症状评分低于针拨组,差异有统计学意义(P<0.05);断线后3d、7d激光组主觉症状评分与同时间针拨组比较,差异均无统计学意义(P>0.05).断线的两组患者断线后1周最佳矫正视力、中央前房深度与断线前比较,差异均无统计学意义(P>0.05);两组患者断线后1周、末次随访眼压与断线前比较,差异均有统计学意义(P<0.05).随访发现均无严重并发症发生.结论:复合式小梁切除术后早期联合激光断线或针拨断线安全有效,临床医生可根据医院及患者条件适当选择.
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