青光眼滤过性手术及其并发症的临床观察  

Clinical observation of glaucoma filter operation and complications

作　　者：张群[1] 左炜[1] 蔡晓华[1] 黄力[1] 

机构地区：[1]深圳市福田区人民医院眼科,518033

出　　处：《临床眼科杂志》2004年第4期328-330,共3页Journal of Clinical Ophthalmology

摘　　要：目的　探讨青光眼滤过手术后并发症的发生原因及处理方法。方法　对接受小梁切除术和深层巩膜咬切术两种滤过手术治疗的 1 5 0只眼术后眼压变化 ,以及 2 4只眼发生浅前房、前房积血、虹膜睫状体炎、角膜水肿、晶状体浑浊、脉络膜脱离和干眼症的原因进行临床分析。结果　 1 5 0只眼术后眼压基本控制在正常范围 ,两种术式后眼压下降幅度基本相当。并发症发生率 2 1 .3% ,其中 ,浅前房 1 2只眼 (8.0 % ) ,前房积血 6只眼 (4 .0 % ) ,虹膜睫状体炎 5只眼 (3.3% ) ,角膜水肿 4只眼 (2 .7% ) ,晶状体浑浊 3只眼 (2 .0 % ) ,脉络膜脱离 1只眼 (0 .7% ) ,干眼症1只眼 (0 .7% )。浅前房以小梁切除术发生率高 ,其他并发症则以巩膜层间咬切术多见。采用加压包扎、扩瞳抗炎、激素等治疗后均恢复 ,浅前房形成 ,前房出血、虹膜炎症全部吸收。结论　明确青光眼滤过手术后并发症的原因并采用积极的治疗措施 。Objective To reduce the complication after filtering operation through investigation in its cause and management.Methods Investigating the cause of IOP change in 150 eyes respectively undertaking trabeculectomy an deep sclerectomy,and the cause of shallow AC(anterior chamber),hyphema,irdocyclitis,corneal edema,lens opacity,choroidal detachment,and xerophthalmia in 24 of these 150 eyes.Results IOP under controlled in all 150 eyes post opertion.The extent of IOP decrease in both operations has no significant difference.The incidence rate of post operation complication is 21.30%,including shallow AC in 12 eyes(8.0%),hyphema in 6 eyes(4.0%),iridocyclitis in 1 eyes(0.7%),and xerophthalmia in 1 eye(0.7%).Comparing the two operations,shallow AC is more likely to be seen in trabeculectomy,while other complications are more often seen in subliminal sclerectomy.The complications can be well controlled after proper treatments like compression bandage,mydriasis,and cortisol,and anti inflammation therapy.AC depth is maintained,hyphema and cortisol idocyclitis is eliminated.Conclusion The complication after glaucoma filtering operation can be prvented and well controlled when its causes are known and initiative remedy is taken.

关 键 词：青光眼滤过性手术 并发症 临床观察 前房积血 角膜水肿 晶状体浑浊 脉络膜脱离 

分 类 号：R779.6[医药卫生—眼科]