青光眼术后前房形成不良的处理体会  

Therapeutic experience of avoiding faulty formation of anterior chamber after glaucoma operation

作　　者：孙时英[1] 崔兰[1] 马效工[1] 李顺利[1] 李晋[1] 

机构地区：[1]兰州军区乌鲁木齐总医院眼科

出　　处：《国际眼科杂志》2008年第4期838-840,共3页International Eye Science

摘　　要：目的:对青光眼术前、术后的意外情况和处理不当出现前房形成不良进行分析和探讨。方法:对我院1975/2006的青光眼患者实施不同术式后发生前房形成不良47眼。通过在手术时行眼球加压、减压,前房穿刺术、保护巩膜瓣和避免对眼内组织的损伤。仔细检查和分析,找出原因,采取积极的相应处理。结果:前房形成不良47眼,术后经过药物处理恢复8眼,手术修复结膜、巩膜瓣7眼,结膜转移、对侧移植或羊膜移植3眼,睫状体脉络膜上腔放液5眼,后巩膜下抽玻璃体水囊和前房注气术4眼,前部玻璃体切除4眼,前、中部玻璃体切除7眼,白内障摘除和前房注气术5眼,白内障超声乳化和人工晶状体植入、玻璃体切割术4眼。前房恢复39眼,其余8例中发生结膜巩膜漏眼内炎1眼,角膜失代偿2眼,恶性青光眼和放弃治疗失明5眼。结论:青光眼的滤过手术,在术中和术后出现短暂的浅前房和无前房是允许的。前房延缓形成或久无前房可造成眼部不同程度的严重改变或损害。应密切观察眼压、瞳孔、眼压变化,及时正确处理。AIM：To analyze faulty formation of anterior chamber resulting in a series of abnormal conditions in eyes before and after glaucoma operation.METHODS：Faulty formation of anterior chamber occurred in 47 patients who underwent glaucoma surgery in our hospital from 1975 to 2006.Intra-operative increase and decrease of intraocular pressure,anterior chamber paracentesis and scleral flap protection were performed to them to avoid intraocular injury.In the 47 eyes with faulty formation of anterior chamber,8 eyes were restored with drug therapy after operation,conjunctival and scleral flaps were repaired in 7 eyes,3 eyes underwent conjunctiva transfer,contralateral transplantation or amniotic transplantation,5 eyes underwent suprachoroidal space drainage,4 eyes underwent vitreous water bag suction and anterior chamber inflation under posterior sclera,4 eyes underwent anterior vitrectomy,7 eyes underwent anterior and central vitrectomy,5 eyes underwent cataract extraction and anterior chamber inflation,and 4 eyes underwent cataract phacoe-mulsification,intraocular lens implantation and vitrectomy.RESULTS：Anterior chamber restored in 39 eyes.In the other 8 eyes,conjunctiva sclera leaking endophtalmitis occurred in 1 eye,corneal decompensation occurred in 2 eyes,and malignant glaucoma and blindness occurred in 5 eyes.CONCLUSION：It is reasonable that temporary shallow or no anterior chamber occurs during and after filtration surgery.Anterior chamber delaying formation for long time or no anterior chamber can result in serious alteration or injury in eyes in various degrees.So attention should be paid to intraocular pressure and pupillary change,and correct treatment should be taken in time.

关 键 词：青光眼术后 前房形成不良 处理 

分 类 号：R779.6[医药卫生—眼科]