目的: 探讨小梁切除术两种不同结膜瓣术后功能性滤过泡形成情况。

方法: 比较 372 例(372 只眼) 原发性青光眼不同结膜瓣小梁切除术术后功能性滤过泡形成情况, 其中以角巩缘为基底的结膜瓣 165 只眼, 以穹窿部为基底的结膜瓣 207 只眼。

结果: 术后 1 周对所有患者进行了观察, 3 个月时只有 127 只眼进行了随访。以角巩缘为基底的结膜瓣手术组术后 1 周滤过泡成功率为 83.03 %, 3 个月时为 78.69 %。以穹窿部为基底的结膜瓣手术组术后 1 周滤过泡成功率为 55.07 %, 3 个月时为 53.03 %。两组比较有明显差别。

结论: 本组研究发现, 传统的以角巩缘为基底的结膜瓣术后滤过泡成功率高于以穹窿部为基底的结膜瓣, 其术后降压效果相应亦较好。

Purpoes: To assess the success rate of the formation of functional filtration bleb in eyes undergoing different incision of conjunctiva flap after trabeculectomy.

Methods: To study the formation of functional filtration bleb after trabeculectomy, the result of trabeculectomy with the limbus based conjunctival flap in 165 eyes and the fornix based conjunctival flap in 207 eyes (372 eyes in 372 cases with primary glaucoma in total) was compared.

Results: All patients were observed after trabeculectomy in 1 week, but only 127 eyes were followed up in 3 months. In patients with trabeculectomy using the limbus based conjunctival flap, the success rate of the formation of the filtration bleb was 83.03 % in 1 week and 78.69 % in three months postoperatively, while in those using the fornix based conjunctival flap, the success rate was 55.07 % in 1 week and 53.03 % in 3 months. There was significant difference between the two groups in terms of the success rate of the formation of the filtration bleb.

Conclusions: The result showed that limbus based conjunctival flap was especially effective and had better postoperative intraocular pressure decline.

真菌性眼内炎是临床上少见的眼内感染疾病。因为其诊断延迟和抗真菌药物的有效性有限，因此真菌性眼内炎常常导致视力严重损害。按照感染性途径，真菌性眼内炎包括内源性和外源性，其中外源性眼内炎常见，进展较快，眼部手术术后感染是常见原因之一。小梁切除术是抗青光眼滤过性手术，是目前手术治疗青光眼的有效方法之一。滤过泡相关性眼内炎是其并发症之一，对患者视功能的损害尤为严重。本文通过回顾1例滤过泡相关性真菌性眼内炎患者的临床病例资料，讨论及分析滤过泡相关性的真菌性眼内炎的危险因素及诊治方法。

Fungal endophthalmitis is a disease which is a rare kind of interocular infection in clinic. Fungal endophthalmitis often results in severe visual impairment because of delayed diagnosis and limited effectiveness of antifungal drugs.Fungal endophthalmitis includes endogenous and exogenous endophthalmitis which is common and progresses rapidly. Postoperative infection is one of the common causes of fungal endophthalmitis. Trabeculectomy is an anti-glaucoma filtering operation, and it is one of the effective methods for glaucoma surgery at present. Glaucoma-filtering bleb infection is one of the complications of trabeculectomy, which can lead to severe visual impairment.In this article, we analyzed and discussed the risk factors, diagnosis and treatment methods about the filtering bleb-associated fungal endophthalmitis.