急性闭角型青光眼合并睫状体脉络膜脱离22例  

Acute primary angle-closure glaucoma with ciliochoroidal detachment in 22 cases

作　　者：吴鸿雁[1] 尹金福[1] 吴仁毅[1] 刘俊[1] 姜节凯[1] 

机构地区：[1]浙江大学医学院附属第二医院眼科中心,浙江省杭州市310009

出　　处：《眼科新进展》2007年第12期929-931,共3页Recent Advances in Ophthalmology

摘　　要：目的分析原发性急性闭角型青光眼(acute prima-ry angle-closure glaucoma,APACG)高眼压状态患者并发睫状体脉络膜脱离的临床特征及治疗结果。方法回顾性研究经超声生物显微镜(ultrasound biomicroscopy,UBM)、B超等检查证实22例31眼高眼压状态合并睫状体、脉络膜上腔积液与脱离的APACG患者,对该组患者的眼前部结构、UBM、B超图像特征及治疗结果进行分析与评价。结果22例31眼首诊时眼压(37.61±10.94)mmHg(1kPa=7.5mmHg),中央前房深度(1.68±0.10)mm,眼轴长度(22.80±0.67)mm。UBM显示:睫状体脱离双眼9例、单眼13例;脱离分级:1级15眼,2级10眼,3级6眼;脱离范围:1/2象限6眼,3/4象限7眼,4个象限脱离18眼。4例(7眼)合并脉络膜脱离。临床治疗10眼作YAG激光虹膜切开术,21眼行巩膜瓣松解缝线小梁切除术,随访所有病例眼压控制良好。结论APACG高眼压患者可合并睫状体脉络膜脱离,常规抗青光眼及联合适量糖皮质激素治疗能有效控制该类患者眼压。Objective To analyze the clinical features and treatment of ciliochoroidal detachment in acute primary angle-closure glaucoma （APACG） with state high intraocular pressure. Methods Twenty two APACG patients （ 31 eyes） were determined with ciliochoroidal detachment by ultrasound biomicroscope（UBM） and B ultrasound examination. The anterior anatomical features, UBM and B ultrasound imaging, as well as the treatment outcome of those patients were analyzed. Results The mean IOP of 22 patients at the first visit was （ 37.61 ± 10.94） mmHg（ 1 kPa =7.5 mmHg） with a mean central anterior chamber depth of （1.68 ±0.10） mm and a mean ocular axial length of （22.80 ± 0. 67 ） mm. UBM examination showed nine cases with bilateral and 13 cases with unilateral ciliary detachment. Grading of cliliary detachment revcaled grade 1 in 15 eyes,grade 2 in l0 eyes and grade 3 in 6 eyes. In 6 eyes half ciliary detachment was noticed, while in 7 eyes three quadrants ciliary detachment and in 18 eyes the whole ciliary detachment was observed. Choroidal detachment was found in 7 eyes of four patients. Laser iridotomy was performed in 10 eyes and trabectflectomy was performed in other 21 eyes with successful intraocular pressure control. Conclusion Combination of glycocorticoid and conventional antiglaucoma therapy is effective in the treatment of APACG patients with high intraocular pressure and ciliochoroidal detachment.

关 键 词：原发性急性闭角型青光眼 睫状体脉络膜脱离 超声生物显微镜 小梁切除术 

分 类 号：R775.2[医药卫生—眼科]