碱性化学伤继发青光眼和白内障的手术治疗  

Surgical management for glaucoma and cataract after ocular alkali burn

作　　者：徐建江[1] 张朝然[1] 孙兴怀[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中国实用眼科杂志》2005年第5期484-486,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的评价白内障超声乳化摘除+前段玻璃体切割术及二期阀门管植入术治疗碱性化学伤导致的白内障及继发青光眼的疗效,并对具体操作做一介绍。方法2003年1月～12月我院收治的病程3个月以上,因眼部碱性化学伤继发白内障及青光眼的患者共11例12眼。一期先行白内障超声乳化摘除和前段玻璃体切割术,术后药物控制眼压。术后1个月内施行二期阀门管植入术。随访3～8个月,观察手术并发症、眼压和视功能等情况。结果所有患者术后眼压均能迅速控制。术后1周,眼压在9～16mmHg之间,平均(11.1±4.3)mmHg。视功能得到不同程度的改善。未见顽固性葡萄膜炎反应、视网膜脱离等并发症。结论分阶段行白内障超声乳化摘除和前段玻璃体切割术及阀门管植入术治疗碱性化学伤导致的继发性青光眼和白内障效果良好,为进一步行穿透性角膜移植手术创造条件。Objective To avaluate the combined procedures of phacomucification,anterior vitrectomy and secondary tubs shunts implantation for complicated cataract and secondary glaucoma after ocular alkali burn.Methods 11 case (12 eyes) of patients with at least 3 months of ocular alkali burn history were included in this study during one year period from Jan.2003 to Dec.2003.Phacomucification and anterior vitrectomy was performed at first stage.Anti-glaucoma regiments were continued and adjusted postoperative.Tube shunts implantation was done within one month after the first surgery.All patients were followed 3～8 months.Surgical complications,intraocular pressure and visual acuity were recorded.Results Intraocular pressure could be controlled rapidly in all 12 eyes postoperative.One week after operation,the mean pressure was (11.1±4.3)mmHg.Visual acuity was improved variable.No intractable intraocular inflammation or retinal detachment could be observed.Conclusions Stage performed combined procedures of phacomucification,anterior vitrectomy and tube shunts implantation could manage the complicated cataract and secondary glaucoma after ocular alkali burn effectively.And this procedures were benefit to further penetrating keratoplasty.

关 键 词：碱性化学伤 青光眼 白内障 手术治疗 玻璃体切割术 阀门管植入术 

分 类 号：R779.13[医药卫生—眼科] R779.6[医药卫生—临床医学]