青光眼小梁切除术后脉络膜脱离的原因及防治  

The cause and prevention of choroidal detachment after tradeculectomy for glaucoma

作　　者：孙建初[1] 李赟[1] 

机构地区：[1]南京医科大学附属无锡市人民医院眼科,江苏无锡214023

出　　处：《中华眼外伤职业眼病杂志》2012年第3期214-217,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨青光眼小梁切除术后脉络膜脱离的原因及防治方法。方法对242例（269眼）青光眼小梁切除术后发生的28例（32眼）脉络膜脱离进行回顾性分析。结果28例（32眼）脉络膜脱离发生时间为术后1～5d，平均（3．21±1．22）d，术后脉络膜脱离的发生与术前眼压控制不佳、术中切口偏后及巩膜瓣偏薄有关。通过散瞳、抗炎、加压包扎、应用皮质类固醇及高渗剂等治疗而复位，1例Ⅲ度浅前房行脉络膜上腔放液前房形成而复位，均经UBM检查证实脉络膜下积液吸收。结论青光眼小梁切除术后脉络膜脱离与术前眼压高、术中手术操作不当有关。一般经保守治疗可得到治愈，而早期通过UBM检查发现并采取相应措施可避免严重并发症的发生。Objective To investigate the causes and preventing methods of choroidal detachment after glaucoma filtrating surgery. Methods Glaucoma surgeries were performed in 269 eyes of 242 patients. The causes of 28 patients （32 eyes） complicated with choroidal detachment were discussed by retrospective analysis. Results Thirty-two eye of 28 patients were complicated by choroidal detachment postoperative 1 - 5 days（3.21 ± 1.22） d. The reasons of choroidal detachment were relevant with poorly controlling of intraoe- ular pressure before operation, backward incision and the thin sclera disc slants. Therapeutic methods were mydriasis, anti-inflammation, pressure bandage, corticosteroid and hyperosmotic solution. One patient with grade Ⅲ shallow anterior chamber was operated by suprachoroidal drainage. All of them proved by UBM. Conclusion The major reasons of choroidal detachment after glaucoma filtration surgery are high preoperative intraocular pressure and improper operation. UBM could effectively detect complications in early stage.

关 键 词：青光眼 小梁切除术 脉络膜脱离 

分 类 号：R779.6[医药卫生—眼科]