| Objects: Primary angle closure glaucoma (PACG) is the main type of glaucoma in China, its rate is 79.60% - 86.13% in glaucoma, and it's one of diseases which induce blindness. The incidence inducing blindness is 19.62% . Therefore the therapy of glaucoma is very important. At present, trabeculectomy is the main method in treating PACG, but there are many complications such as postoperative shallow anterior chamber, choroidal detachment and so on . Recently for controlling postoperative shallow anterior chamber and other complications ophthalmologists do trabeculectomy with releasable sutures successfully. This paper is to observe postoperative visual acuity, filtering blebs, anterior chamber and other conditions. We can provide theoretical foundation for treating PACG.Methods: One hundred forty-eight patients (166 eyes) with primary angle closure glaucoma were chosen from the patients treated at the eye department General Hospital, Tan Jin Medical University and Pipeline Bureau Hospital LangFang between 1998 and 2001. 80 eyes received trabeculectomy with releasable sutures while 86 eyes underwent normal trabeculectomy. The questionnaire included age, gender, family history, inducement, systemic diseases , the incident season, the visual acuity and IOP of preoperationand postoperation, postoperative filtering blebs and complications , such as shallow anterior chamber, choroidal detachment and so on . Then the data were sorted according to every element observed and the comparable data were statistically analyzed. Results: We observed 166 eyes of 148 patients ( 87 women and 61 men ) with PACG .Their mean age is 64.24 years. The rate of females of all patients is 58.8%, the most prevalent age is 60-80 years. The rate associated systemic diseases ( for example hypertension, heart disease, diabetes and so on ) is 36.49%. The rate of inducement is 15.54%. The attack of glaucoma is usually in the spring and winter(56.1%). The rate of color blindness is 15.54%. The number of patients whose visual acuity is from 0.3 to 0.9 increased in the suture and normal group. There is no significant difference between the two groups in preoperative visual acuity and IOP(P>0.05).There is also no significant difference in postoperative visual acuity and IOP (P> 0.05 ). There is significant difference between preoperative and postoperative IOP in suture group and normal group (P<0.001). There is significant difference between the two groups in the incidence of the effective filtering blebs (P<0.01). There is significant difference between the two groups in the incidence of postoperative flat anterior chamber ( 1 day and 3 day PO.01, 6 day and 7-15 day, PO.05). The cause of postoperative flat anterior chamber is excessive filtration, choroidaldetachment and conjunctival flap flushing. But flat anterior chamber5and choroidal detachment is main. The incidence of excessive filtration is 49.1% and the incidentce of choroidal detachment is 40% The difference is significant between the two groups in excessive filtration and choroidal detachment (P<0.05). The difference isn't significant in conjunctival flap flushing (P>0.5).If the preoperative IOP is normal, the incidence of the flat anterior chamber of postoperation is 45.92%, under the high preoperative IOP, the incidence of the flat anterior chamber of postoperation is 64.71%. There is significant difference between the high IOP group and normal IOP group in incidence of flat anterior chamber (P<0.05). The choroidal detachment often occur at 3-7days after the surgery. There is significant difference between the two groups in incidence of choroidal detachment (P<0.05) and it usually recovered in one week. If the preoperative IOP is normal , the incidence of the choroidal detachment is only 7.14%, If the preoperative IOP is high, the incidence of the choroidal detachment is 22.06% . There is significant difference between high IOP groupand normal IOP group in it (P<0.01).Conclusion: K The difference of postoperative visual acuity andIOP between the two groups... |
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