高眼压下急性闭角型青光眼小梁切除术的临床观察  

Clinical observation of trabeculectomy for acute angle-closure glaucoma with high intraocular pressure

作　　者：卢建香[1] 刘芳[1] 张林霞[1] 

机构地区：[1]焦作市第二人民医院眼科,河南焦作454001

出　　处：《眼外伤职业眼病杂志》2008年第10期799-801,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的探讨急性闭角型青光眼发作期持续高眼压状态下行小梁切除术的可行性及效果。方法对应用大剂量降眼压药物2～3d后眼压仍持续在40mmHg以上的40例（65眼）行小梁切除术；术中均在切除小梁组织前在巩膜瓣根部中央角膜缘处用剃须刀刺开一小切口，缓慢放出房水，眼压降低后再常规完成手术。结果本组术中及术后均未出现暴发性脉络膜上腔出血、恶性青光眼等严重并发症，术后1周视力≥O．1者64眼；视力≥0．3者39眼；眼压≤21mmHg者52眼；术后3眼出现脉络膜脱离，7眼前房形成延缓，经治疗后逐渐恢复。本组病例手术后大多数保留了较好的视力。结论药物不能控制眼压的急性闭角型青光眼，及时行前房穿刺加小梁切除术手术治疗十分必要，可以避免视功能的进一步损害。Objective To evaluate the trabeculectomy for acute angle-closure glaucoma （ACG） attack with continuous high state of intraocular pressure （IOP）. Methods Trabeculectomy had been done for 40 cases （65 eyes） of ACG that the IOP was over 40 mmHg after application of large dose of medicine treatment; After the scleral valve had been done, a small incision was made to release aqueous slowly. Then regular operation had been done when the IOP droped. Results There were no serious complications such as suprachoroidal space bleeding and malignant glaucoma. The vision was ≥0. 1 in 64 eyes in one week, ≥0.3 in 39 eyes. The IOP was ≤21 mmHg in 52 eyes. Choroidal detachment occurred in 3 eyes. Delayed anterior chamber reformation occurred in 7 eyes. Most of the cases got a good vision. Conclusion It is necessary to do anterior chamber puncture and trabeculectomy for ACG with continuous high state of IOP.

关 键 词：闭角型青光眼 急性 小梁切除术 高眼压 前房穿刺 

分 类 号：R779.6[医药卫生—眼科]