News

微创手术治疗青光眼 助降低风险加快康复

Lianhe Zaobao (15 March 2018) - 新的微创青光眼手术法使用的是类似注射器的工具, 把细管植入眼球内,导出眼球内分泌的液体,以降低 眼压,虽然仍然使用外科手术设备降低眼压,但医生 几乎无需在眼球上开刀。

Exclusive article in Zaobao on new surgical options to treat Glaucoma patients. Patients can now choose Minimally Invasive Glaucoma Surgery (MIGS) which has a lower surgical risk and shorter recovery time.

Dr Leonard Yip, Senior Consultant and Head of Glaucoma Service, NHG Eye Institute at TTSH, said the new minimally invasive technique uses syringe-like tools, inserting a thin tube into the eyeball and extracting the eye fluid and reducing the eye pressure. Traditionally, glaucoma surgery involves creating a significant dissection on the eye to create an outlet for the fluid to flow through. This procedure is complicated and may result in a large wound. Hence, there is a higher risk, longer recuperation time and possibility of complications. So far, around 70 patients have opted for this minimally invasive procedure since it was introduced in TTSH last year.

TTSH's patient Mdm Low had both types of surgery done on her eyes – regular glaucoma surgery was done on the left eye while the minimally invasive glaucoma surgery was done on the right eye. “After surgery on my left eye, I had to wear sunglasses when I went out and had to wear them for over a month. But I did not have to for my right eye.” said Mdm Low. She mentioned that after the surgery, her vision was clear and she did not have to apply eye drops.


青光眼患者现在可以选择通 过微创手术治疗青光眼,降低青 光眼手术风险,同时缩短康复时间。   

国立健保集团青光眼服务主 管叶伟良医生昨日接受《联合早 报》访问时说,新的微创手术法 使用的是类似注射器的工具,把 细管植入眼球内,导出眼球内分泌的液体,以降低眼压。

青光眼疗法一般是通过滴眼 药水降低眼压,减轻视觉神经承受的压力。严重患者则需动手术,把无法自然排放的液体导出,以免液体不断累积,导致眼压增加。

叶伟良说:“微创青光眼手术仍然使用外科手术设备来降低眼压,但医生几乎无需在眼球上开刀。”

他说,长久以来,青光眼手术是在眼球壁上开刀,制造缺口让液体通过出口流出。这种手术步骤复杂,伤口较大,因此风险较高,康复时间也比较长,而且可能出现并发症,如导出液体太多。

叶伟良也是陈笃生医院眼科部门高级顾问。他说,陈笃生医院去年中开始用微创手术法为青光眼患者植入细管,接受此类治疗者至今共计70人。

动手术可减少或取代使用眼药水

叶伟良说,陈笃生医院使用的细管有两种,一种是用柔软又具有伸缩性的材料制成的细管,有六毫米长,另一种则是用钛制成的短管,长度为一毫米,目前各有35名病人使用。

他说,使用眼药水控制眼压是持久性的疗法,病人需要不断购买眼药水,经常费用可能成为负担,而且这种疗法需要病人配合,按时滴眼药水。反之,动手术可以减少或取代使用眼药水,一劳永逸。

此外,有少数病人对眼药水过敏,因此得动手术治疗青光眼。

陈笃生医院在微创手术后追踪病人的情况发现,使用柔软细管者有96.3%在术后一个月内无需再用眼药水控制眼压,使用钛制短管者则有71.4%。

不过,微创手术的费用比原来的青光眼手术费用高。叶伟良说,这是因为植入体成本较高,一支柔软细管或一双钛制短管要 2000元。

刘丽卿(71岁,退休保姆)动过两种手术,左眼是一般青光眼手术,右眼则是微创手术。她受访时说:“左眼动完手术后,出门得戴墨镜,要戴一个多月,右眼则不用。”

她也说,动完手术后,她的视力很清楚,而且不用再滴眼药水。


Download PDF

Source: Lianhe Zaobao © Singapore Press Holdings Limited. Permission required for reproduction.