非穿透小梁手术后高眼压的早期房角镜检查  

Early gonioscopy after nonpenetrating trabeculectomy with high intraocular pressure

作　　者：郑磊[1] 张建华[1] 仲明[1] 沈炜[1] 刘志勇[1] 桑延智[1] 张媛[1] 吴晋辉[1] 

机构地区：[1]第二军医大学第一附属医院眼科,上海200433

出　　处：《眼外伤职业眼病杂志》2005年第12期899-901,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的观察非穿透小梁手术后高眼压的房角及小梁前弹力膜滤过窗的改变。方法对5例(5眼)开角型青光眼住院行非穿透小梁手术术后早期发生高眼压者,早期行前房角镜检查。结果1眼小梁后弹力膜过厚滤过不畅,4眼术区房角滤过窗阻塞,其中2眼周边虹膜与术区小梁后弹力膜相接触阻塞滤过窗,1眼前房积血术区前房角见血凝块,1眼巩膜减压液腔内积血。治疗后术区前房角滤过窗口重新开放眼压降至正常范围。结论术后早期高眼压与内部阻塞因素有关,早期非常规情况下的前房角镜检查,对分析判断早期高眼压的原因有十分重要的作用。Objective To study the appearance of anterior chamber angle and trabeculo-Descemet＇ s membrane after nonpenetrating trabeculectomy with high intraocular pressure. Methods 5 patients who underwent nonpenetrating trabeculectomy for open-angle glaucoma were included in a non-randomized clinical study. Postoperatively, the high intraocular pressure was found, early gonioscopy was performed between 3 and 15 days postoperatively in all patients. Results Peripheral anterior synechia of iris or touch between iris and trabeculo-Descemet＇ s membrane was found in 2 eyes;there was 1 eye occuring hyphema in early period after operation, cruor was found in the angle of surgical site; thick of trabeculo-Descemet＇ s membrane and low filtration through it in 1 eye; and bleeding in the corneosclera cavity in 1 eye. Intraocular pressure of all 5 eyes had come to normal after treatment. Conclusion Postoperatively, the high intraocular pressure was related to the block of trabeculo- Descemet＇ s membrane. We could find and analysis the condition of angle and filtration timely and managed properly by examining angle of anterior chamber with gonioscope after operation in early period.

关 键 词：非穿透小梁手术 前房角镜检查 虹膜 青光眼 眼压 

分 类 号：R779.6[医药卫生—眼科]