青光眼术后继发恶性青光眼19例手术疗效观察  

Clinical investigation on management of 19 cases malignant glaucoma after glaucoma surgery

作　　者：杨新光[1] 刘钊[2] 郭斌[3] 于敬妮[1] 刘建荣[1] 肖燕[2] 

机构地区：[1]中国陕西省西安市第四医院眼科陕西省眼科医疗中心,710004 [2]西安交通大学医学院,中国陕西省西安市710061 [3]解放军81医院眼科,中国江苏省南京市210002

出　　处：《国际眼科杂志》2009年第5期877-878,共2页International Eye Science

基　　金：中国陕西省卫生厅科学研究基金资助项目(No.06D17)~~

摘　　要：目的:评估前部玻璃体切除晶状体摘除联合小梁切除手术治疗恶性青光眼的临床效果。方法:我们回顾了19例(19眼)恶性青光眼患者接受前部玻璃体切除晶状体摘除联合小梁切除手术治疗的病例。恶性青光眼发生前青光眼包括急性闭角型青光眼4眼,慢性闭角型青光眼11眼,开角型青光眼2眼,先天性青光眼2眼。曾行手术包括虹膜周边切除术3眼,小梁切除术16眼。手术前后均进行最佳矫正视力、眼压和裂隙灯显微镜检查。结果:有15眼术后最佳矫正视力较术前均有不同程度提高。患者术前眼压为41.33±13.85mmHg;术后眼压降低为14.23±4.88mmHg。术后患者前房形成,术后早期炎症反应较重,术后4d减轻。术后常见的并发症包括角膜内皮水肿、皱褶和少量玻璃体脱入前房。结论:前部玻璃体切除晶状体摘除联合小梁切除手术是治疗恶性青光眼的有效方法。AIM ： To investigate the clinical efficacy of the combined surgery of trabeculectomy, lensectomy and anterior vitrectomy in the management of malignant glaucoma. METHODS： This study was a retrospective medical records review of 19 eyes of 19 patients who accepted the combined surgery of trabeculectomy, lensectomy and anterior vitrectomy for treatment of malignant glaucoma. Of the 19 eyes, this included 4 acute angle closure glaucoma, 11 chronic angle closure glaucoma, 2 open angle glaucoma and 2 congenital glaucoma. Prior to the emergence of malignant glaucoma, 3 had undergone iridectomy, 16 had undergone trabeculectomy. Available documents on pre- and post-surgical best corrected visual acuity, intraocular pressure and slit lamp microscope check were evaluated. RESULTS： After the injection, the best corrected visual acuity of 15 of the patients improved. Pre-surgical intraocular pressure was 41.33 ± 13.85mmHg （1mmHg = 0. 133kPa） and post-surgical intraocular pressure decreased to 14.23 ± 4.88mmHg. The anterior chambers of all eyes formed and the intraocular inflammation of the surgical eye persisted for 4 days. Post-surgical complications included edema and wrinkle of corneal endothelium and prolapse of vitreous body in anterior chamber. CONCLUSION： The combined surgery of trabeculectomy, lensectomy and anterior vitrectomy may be effective in the management of malignant glaucoma secondary to glaucoma surgeries.

关 键 词：恶性青光眼 手术 眼压 视力 并发症 

分 类 号：R779.6[医药卫生—眼科]