前房型人工晶体植入术后继发性青光眼  

Secondary glaucoma after anterior chamber intraocular lens implantation

作　　者：吴玲玲[1] 尹金福[1] 姚克[1] 吴仁毅[1] 

机构地区：[1]浙江医科大学附属第二医院眼科中心

出　　处：《中华眼科杂志》1999年第3期183-185,共3页Chinese Journal of Ophthalmology

摘　　要：目的了解前房型人工晶体（ａｎｔｅｒｉｏｒｃｈａｍｂｅｒｉｎｔｒａｏｃｕｌａｒｌｅｎｓ，ＡＣＩＯＬ）植入术后对眼压、房角的影响及继发性青光眼的发生情况。方法回顾调查６２只眼ＡＣＩＯＬ植入术后，随访期为３个月至７年，平均３１个月，眼部检查着重房角的检查。白内障类型以外伤性及老年性为主。手术方式包括眼前段切除术或白内障囊外摘除（ｅｘｔｒａｃａｐｓｕｌａｒｃａｔａｒａｃｔｅｘｔｒａｃｔｉｏｎ，ＥＣＣＥ）结合ＡＣＩＯＬ植入等。结果术后虹膜周边前粘连发生率为８７．１％。继发性青光眼发生率为１１．３％，主要为闭角型；其发生与手术方式有关，ＥＣＣＥ后Ⅰ期或Ⅱ期ＡＣＩＯＬ植入术后青光眼发生率为１７．４％，结合眼前段切除术后，发生率降为０％。结论ＥＣＣＥ时晶体后囊破裂玻璃体脱出引起严重葡萄膜反应及瞳孔阻滞可能是青光眼发生的主要病因，应结合眼前段切除术，以预防其发生。Objective To investigate the intraocular pressure level, the change of anterior chamber angle and the occurrence of secondary glaucoma after anterior chamber intraocular lens (ACIOL) implantation. Methods Sixtytwo ACIOL implanted eyes were followed up postoperatively for 3 months to 7 years (mean 31 months). The examination of anterior chamber angle was emphasized. The type of cataract mainly included senile and traumatic. The operation performed were lensectomy with anterior vitrectomy or extracapsular cataract extraction (ECCE ) combined with primary or secondary ACIOL implantation. Results The incidence of postoperative peripheral anterior synechia (PAS) of iris was 87.1% and that of the secondary glaucoma (mainly the angleclosure) was 11.3%. The incidence of the glaucoma after ECCE with primary or secondary implantation was 17.4%, while that after ECCE combined with anterior vitrectomy was 0%. Conclusion The main causes of the secondary glaucoma are possibly the rupture of posterior capsule and vitreous loss during the surgery leading to postoperative severe uveitis and pupillary block. To prevent its occurrence, it is important to combine ECCE with anterior vitrectomy.

关 键 词：青光眼 白内障 人工晶体植入术 手术后 

分 类 号：R776.106[医药卫生—眼科] R775.3[医药卫生—临床医学]