青光眼滤过手术后浅前房的观察及处理  

Observation and therapy of shallow anterior chamber formed after trabeculectomy in patients with glau- coma

作　　者：骆荣江[1] 马翠萍[1] 黄静文[1] 彭玲妹[1] 朱慧萍 刘韶瑞[1] 

机构地区：[1]中山大学附属第一医院眼科,510080 [2]南雄市中医院眼科

出　　处：《中国临床实用医学》2009年第6期43-44,共2页China Clinical Practical Medicine

摘　　要：目的探讨青光眼滤过术后浅前房的发生原因及处理方法。方法分析施行穿透性或非穿透性小梁手术的青光眼患者共158例（186眼）的术后情况。结果①术后浅前房：穿透性小梁手术组（93例）32眼，发生率34．41％；非穿透性小梁手术组（93例）3例，发生率为3．23％，两组差异有显著统计学意义（X^2=7．891，P=0．003）；②浅前房的原因：35例浅前房中，脉络膜脱离20眼（占57．14％），引流过畅8眼（22．86％），房水生成不足4眼（11．43％），结膜渗漏2眼（5．71％），恶性青光眼1眼（2．86％）；③浅前房发生的多因素分析表明，与青光眼类型（回归系数β=4．214，P〈0．01）及年龄（p=5．176，P〈0．01）有显著相关性，与性别（β=0．363，P=0．859）无关。结论非穿透小梁切除术可显著降低浅前房的发生率；术者应注意浅前房的易发因素以降低术后浅前房发生率。Objective To analyze the causes for the formation of shallow anterior chamber after trabe- eulectomy in patients with glaucoma and its treatment. Methods A total of 186 eyes of 158 subjects with glau- coma who underwent penetrating and non-penetrating trabeculectomy were reviewed retrospectively. Results Shallow anterior chamber occurred in 32 eyes （32/93,34.41% ） in penentrating trabeeulectomy group, 3 eyes （3/93,3.23%） in non-penetrating trabeculeetomy group. Choroidal detachment （ 20,57. 17% ）, excessive drainage through filtration track （ 8,22. 86 % ） , low production of aqueous humor （ 4,11.43 % ） , the leakage of chamber fluid （2,5. 71%） and malignant glaucoma （ 1.2. 86% ） were the main causes for the development of shallow anterior chamber postoperatively. The correlations between the development of shallow anterior chamber and the type of glaucoma （β= 4. 214, P 〈 0. 001 ）, and age （β= 5. 176, P 〈 0. 001 ） were statistically signifi- cant. It was not associated with gender （β= 0. 363, P = 0. 859 ）. Conclusion Non-penetrating trabeculectomy is a safe technique that significantly reduces the incidence of immediate postoperative shallow anterior chamber. Attention should be paid to the risk factors of the development of shallow anterior chamber postoperatively.

关 键 词：青光眼 滤过手术 浅前房 

分 类 号：R779.6[医药卫生—眼科]