晚期青光眼手术后视功能状况分析  

The Postoperative Visual Functions in Advanced Glaucoma Patients

作　　者：葛玲[1] 孙兴怀[2] 

机构地区：[1]上海市眼病防治中心,200040 [2]复旦大学附属眼耳鼻喉科医院眼科,上海200031

出　　处：《中国眼耳鼻喉科杂志》2006年第1期31-33,共3页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的选择晚期青光眼病例,就其青光眼手术后的视功能状况作随访,以期指导临床治疗策略的制定。方法晚期青光眼患者43例(46眼),随访7～60个月(27.5±15.9个月)。疗效判定标准:抗青光跟手术后不用或仅用局部降眼压药物,眼压≤21mmHg,且视野缺损不进展者作为手术成功标准。结果患者1、2、3、4、5年的手术成功率分别为87.0%、78.3%、69.6%、60.9%及56.5%,平均随访眼压值升高是手术成功率的危险因素(P=0.012)。术后并发白内障(t=-2.954,P=0.005)及平均随访眼压升高(t=-2.551,P=0.014)是术后视力下降的危险因素。术后平均随访眼压值升高是视野缩小的危险因素(P=0.012)。结论治疗晚期青光眼,控制眼压至关重要,但不能以正常统计学范同的眼压值为目标,应寻找其靶眼压。Purpose To study the postoperative visual functions in advanced glaucoma patients.Methods Fortythree advanced glaucoma patients（46 eyes） were followed up 7 - 60 （27.5 ± 15.9） months postoperatively. The definition of successful surgery： intraocular pressure （IOP）≤21mmHg and no progressive visual field defect after antiglaucoma surgery.Results The success rate of operation was 87.0% ,78.3% ,69.6% ,60.9% and 56.5% at 1,2,3,4,5 years respectively and it was found that the increased mean follow-up lOP was associated with low success rate of surgery （ P = 0.012）. The risk factors responsible for reduced postoperative best corrected visual acuity （BCVA） were complicated cataract after surgery（ t = - 2.954, P = 0.005）and the increased mean follow-up IOP （ t = - 2.551, P = 0.014）. It was found that the increased mean follow-up IOP was the risk factor for the progression of the visual field postoperatively （ P = 0.012） . Conclusion It is target pressure not the IOP among the statistical range that is important for defect the therapy of glaucoma especially advanced glaucoma.

关 键 词：晚期青光眼 视功能 视野 靶眼压 

分 类 号：R779.6[医药卫生—眼科]