睫状体扁平部造瘘术的临床应用  

Clinical application of the ciliary body flat fistulation

作　　者：金威尔[1] 刘安[1] 张俊华[1] 

机构地区：[1]福建中医学院附属人民医院眼科,福州350004

出　　处：《中国中医眼科杂志》2007年第1期1-3,共3页China Journal of Chinese Ophthalmology

基　　金：福建省教育厅科技项目(JB99090)

摘　　要：目的探讨睫状体扁平部造瘘术的适应证及治疗顽固的难治性青光眼的有效性与安全性。方法对排除了眼内肿瘤，眼前段不存在相对较深的前房角及前房的顽固的难治性青光眼，包括新生血管性青光眼、非新生血管性青光眼及角膜葡萄肿用睫状体扁平部造瘘术治疗，并进行随访。结果随访6个月～2年，15例15眼的眼压均控制在正常范围，解除了头眼疼痛症状，眼球得以保存。新生血管性青光眼中新生血管消失，其中1例糖尿病性新生血管性青光眼视力从眼前数指提高到0．05；角膜葡萄肿病情控制。2例术后早期因滤泡瘢痕化或／和巩膜瓣板层粘连导致眼压再次升高，经切除瘢痕，分离粘连的巩膜瓣，术后第3天施行眼球按摩并配合结膜下注射5-FU，维持了滤过道的通畅。其中2例随访9年，1例发生眼球轻度萎缩伴废用性外斜视，1例眼压轻度升高，需予塞吗心胺点眼，可控制眼压。结论睫状体扁平部造瘘术为不存在相对较深的前房角及前房的顽固的难治性青光眼及角膜葡萄肿的手术治疗提供了可能和新的选择。OBJECTIVE To investigate the indication of the ciliary body flat fistulation and curative effect to tenacious and complex glaucoma.METHODS Ruling out intraocular tumour, operate the ciliary body flat fistulation on tenacious and complex glaucoma without relative deep anterior chamber angle and anterior chamber, including neovascular glaucoma, none neovascular glaucoma and conophthalmus. And follow up. RESULTS Followed up six months to two years. Intraocular tension of 15 cases 15 eyes were controlled in normal limits, headache and ophthalmalgia were relieved, eyeballs were survived. New vessels disappeared in neovascular. Vision of one diabetic neovascular glaucoma case was raised from cotmting fingers before eye to 0.05. Conophthalmus were controlled. By cutting scar, separating adhesive scleral flap, performing eyeball massage three days after operation and subconjunctival injecting 5 - FU, filtered passageway maintained clear of two cases whose intraocular tension increased again because of follicle scarring or/and scleral flap layers conglutination nonage after operation. Two cases followed up 9 years, one happened eyeball atrophy slightly, intraocular tension of another case increased, which were controlled by timolol. CONCLUSIONS The ciliary body flat fistulation has provided a possible and new choice for operation of tenacious and complex glaucoma without relative deep anterior chamber angle and anterior chamber conophthalmus.

关 键 词：睫状体扁平部 青光眼 造瘘术 

分 类 号：R779.62[医药卫生—眼科]