دراسة تأثير خزع قناة شليم بالمواد اللزجة على جراحة الزرق البدئي المفتوح الزاوية غير المنوسرة خبرة مشفى الأسد الجامعي باللاذقية في الفترة 2006 - 2007
Abstract
يوضح هذا البحث ضرورة الاهتمام بالزرق البدئي المفتوح الزاوية لكونه مرضاً مزمناً لا عرضياً يصيب البالغين< 40 سنة، وتتجه المدارس العالمية في معالجة الزرق نحو العلاج الجراحي غير النافذ بسبب قلة اختلاطاته. شملت دراستنا (15) مريضاً( 15عين) مصاباً بالزرق البدئي المفتوح الزاوية راجعوا العيادة العينية خلال عامي2007-2006 ، توزعوا بين ذكور (73.3%) ، وإناث (26.7%) ، أجري لهم جراحة زرق غير نافذ مع خزع قناة شليم بالمواد اللزجة ، وكانت النتائج : بلغ معدل النجاح في المحافظة على الضغط داخل المقلة21> ملمز (87%) - الحد الأعلى لانخفاض الضغط بهذه الطريقة 15 ملمز - بلغ معدل النجاح النهائي(80.25%) . كانت الاختلاطات المشاهدة قليلة وقد تمت السيطرة على بعضها ، وخضعت الحالات غير المستجيبة للجراحة الراشحة أو العلاج الليزري المتمم، أهم الاختلاطات بعد العمل الجراحي الفشل المتأخر (19.75%)،وكانت أهم أسبابه فشل التصريف المتأخر نتيجة التندب . لذلك ينصح باعتماد هذه الطريقة عند المرضى الذين يبلغ الضغط داخل العين عندهم < 35 ملمز.
This study attempts to explain the importance of the primary open angle glaucoma which is a chronic, asymptomatic disease. Medical schools are expected to depend on non-penetrating surgery because of much complications of penetrating surgery. The study was applied on 15 patients, with POAG , who visited the Ophthalmic Clinic at Al-Assad University Hospital ( Lattakia) between 2006-2007. 73.3 % of them were males and 26.7% were females. These patients underwent viscocanalstomy. The results have been registered for 6 months: the final rate of success was 80.25%; the maximum decrease of IOP was 15 mmHG. Complications were rare and failure cases underwent trabeculectomy or laser therapy. The most important postoperative complication was late failure of filtration (19.75%).
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