小梁切除联合手术治疗瞳孔膜闭继发性青光眼  

Clinical research of trabecular resection combined with pupillary organization membrane resection in the treatment of secondary glaucoma associated with pupillary occlusion

作　　者：孟海林[1] 张宏亮[1] 马锦霞[1] 常新琦 何颜清 王瑞[1] 

机构地区：[1]安阳市眼科医院,河南安阳455000

出　　处：《眼外伤职业眼病杂志》2006年第10期762-764,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的评价小梁切除联合瞳孔区机化膜切除治疗瞳孔膜闭继发青光眼的临床治疗效果。方法对瞳孔膜闭继发青光眼17例（17眼）行小梁切除联合虹膜和瞳孔后粘连分离、周边虹膜前粘连和房角分离、瞳孔区机化膜切除。术后对眼压、视力、滤过泡、并发症等进行临床观察。结果随访6月-3．5年，平均（1．79±0．55）年。术后眼压（17．46±2．23）mmHg，与术前相比较，差异有统计学意义（P〈0．01）。术后视力0．01-1．0，平均0．71±0．14，与术前0．002—0．4相比，差异有统计学意义（P〈0．01）。滤过泡Ⅰ型4例，Ⅱ型8例，Ⅲ型4例，Ⅳ型1例。术后并发症有轻度房水闪光（17／17）及少量前房积血（6／17）。结论小梁切除联合虹膜和瞳孔后粘连分离、周边虹膜前粘连和房角分离、瞳孔区机化膜分离和切除，对瞳孔膜闭继发青光眼在有效控制眼压和提高视力方面有良好的效果。Objective To research the clinical results of combined trabecular resection with pupillary organization membrane resection in the treatment of secondary glaucoma associated with pupillary occulusion. Methods The present study consisted of 17 cases（ 17 eyes） with trabecular resection combined with posterior synechia separation of the pupil and iris, peripheral anterior synechia separation of the iris and pupillary organization membrane resection. Post-operative IOP, visual acuity,filtrations bleb and complication were monitored. Results The average follow-up time was 1.79± 0.55 years. There was significant difference in IOP between preoperative group （ averaged IOP 17.46 ± 2.23mmHg） and postoFeration lOP （25.87 ± 5.86 mmHg）. 14 eyes （82.35% ） have average lOP of 16.57 ± 1.39 mmHg. 2 eyes （11.76% ）have average lOP less than 21mmHg combined with single anti-glaucoma medicine. 1 cases （5.88%） has lOP more than 30 mmHg and were treated with surgery again. The average postoperation visual acuity were 0.71 -0. 14（0.01 to 1.0） .The preoperative visual acuity were 0.18±0.06（0.002 to 0.4）. There has significant difference in the two groups, According to Kronfcld classification of filtration bleb.4 cases （23.53%） was Type Ⅰ.8 cases（47.06% ） was Type Ⅱ ,4 cases （23.53%） was Type Ⅲ .1 cases （5.88%） was Type Ⅳ .The complications included anterior chamber Tyndall phenomenon（17/17） and anterior chamber hemorrhage （ 6/17 ）. Conclusions Trabecular resection combined with posterior synechia separation of the pupil and iris, peripheral anterior syneehia separation of the iris and pupillary organization membrane resection is a better treatment in control IOP and improve visual acuity for secondary glaucoma associated with occlusion of pupil.

关 键 词：瞳孔膜闭 继发性青光眼 小梁切除 瞳孔区机化膜切除 

分 类 号：R779.6[医药卫生—眼科]