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Non-penetrating trabeculectomy combined trabeculotomy for primary open-angle glaucoma

Scleral flap NPTS cutting the underlying technology of filtration membrane function is good, is the key to successful operation L5J. Scleral flap in time for the deep depth of Schlemm pipe must wall, the deep tissues and sclera together with the tube outer wall tissue Schlen ~ n be removed, exposing a trabecular Descemet membrane. This requires a lamellar scleral flap surgery correctly identified the external standard state three bands: the cornea with a transparent, gray and blue with the trabecular meshwork,[link widoczny dla zalogowanych], sclera white belt, and can accurately locate Schlemm tube. When the removal of the outer wall Schlemm tube, adjacent to Schlenml line pipe trabecular and pre-Descemet's membrane corneal stromal tissue,[link widoczny dla zalogowanych], aqueous humor from the trabecular or after a complete internal elastic membrane leakage. Aqueous overflow surgery successful operation is based, POAG pathogenesis are: (1) trabecular meshwork cells of the extracellular matrix composition and content changes to the trabecular mesh narrow and collapse; (2) of trabecular cells The content and composition of cell contraction abnormal skeleton, so that the contraction of trabecular meshwork cells decreased trabecular meshwork cells to ask small or rigid mesh, so that the aqueous outflow obstruction, increased intraocular pressure 6. We know that the main resistance to aqueous outflow in Schlemm site adjacent tubes in endothelial and trabecular, NPTS surgery in order to increase the excretion of aqueous and improve the success rate, we combined the trabeculotomy. Trabeculotomy for the surgical principle is outside the road from the trabecular meshwork and Schlemm cut the inner wall of the front room and a direct link between Schlemm tube to facilitate the aqueous discharge. In the NPTS combined trabeculotomy surgery, generally only cut one side (60.), Can significantly increase the amount of housing the overflow of water, but will not be shallow anterior chamber and iris prolapse. Surgical characteristics: (1) conjunctival flap in the superficial scleral flap and the use of MMC (a concentration of 0.04g · LI1); (2) removal of the superficial layer of corneal and scleral tissue, together with the tube outer wall of Schlemm, trabecular one after exposure to elastic membrane; (3) trabecular cutting knife inserted into Schlemm tube for trabeculotomy,[link widoczny dla zalogowanych], the general can only cut one side, the water overflow room were more than mere non-penetrating trabeculectomy; (4) patients in the anterior chamber is not shallow, iris waisted; (5) significant postoperative bleb, IOP results are satisfactory,[link widoczny dla zalogowanych], no complications; (6) post-operative care is simple.
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