先天性青光眼术后视网膜脱离的手术治疗  

Surgical treatment of retinal detachment after congenital glaucoma surgery

作　　者：王瑞夫[1] 高晓唯[1] 李霞[1] 董晓云[1] 闫希冬[1] 乔磊[1] 

机构地区：[1]解放军第474医院眼科,乌鲁木齐830013

出　　处：《中华眼外伤职业眼病杂志》2012年第7期518-520,共3页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨先天性青光眼术后视网膜脱离的病因、临床特点及手术效果。方法对8例（8眼）先天性青光眼术后视网膜脱离行平坦部闭合式玻璃体切除联合视网膜切开、剥膜、硅油充填等治疗。术后观察视力、眼压、视网膜复位情况及并发症。结果随访6-24个月，视力提高4眼（50％），不变3眼（37．5％），下降1眼（12．5％）；眼压正常（10-21mmHg）者5眼（62．5％），使用前房穿刺联合降压药物后，眼压正常者2眼（25．0％），经药物及睫状体光凝术后，眼压正常者1眼（12．5％）；7眼首次手术后视网膜复位（87．5％），1眼二次手术后视网膜复位（12．5％）；8眼手术均无严重并发症发生。结论先天性青光眼术后视网膜脱离的病情复杂，玻璃体切除联合视网膜切开有助于视网膜复位，提高视功能，控制眼压的稳定。Objective To investigate the pathology, clinical characteristics and therapeutic effects of retinal detachment alter congenital glaucoma operation. Methods 8 cases （8 eyes） of retinal detachment after congenital glaucoma operation were treated by pars plana vitrectomy （PPV） combined with retinotomy, membrane peeling and silicone oil tamponade. The visual acuity, intraocular pressure, retinal reattaehment and postoperative complications were observed. Results Follow-up period was 6 ~ 24 months after surgery. Visual acuity increased in 4 eyes（50% ） ,maintained in 3 eyes（37.5% ） ,and decreased in 1 eye（ 12.5% ）. The intra ocular pressure of 5 eyes were lower than 21 mmHg（ 1 mm Hg =0. 133 kPa） （62.5%）, 2 eyes lower than 21 mmHg with drugs and paracentesis of anterior chamber（25.0% ）, 1 eye lower than 21 mmHg with drugs and cyclophotocoagulation（ 12.5% ） ; 7 eyes obtained retinal reattachment undergoing once surgi- cal treatment（87.5% ）, 1 eye obtained retinal reattachment after two surgeries（ 12.5% ）. Serious postopera- tive complication was not observed. Conclusion The pathology of retinal detachment after congenital glau- coma operation were complex. PPV combined with retinotomy were helpful for retinal reattachment, which were helpful for visual acuity improvement and normal intraocular pressure.

关 键 词：青光眼 先天性 视网膜脱离 玻璃体切除术 视网膜切开 

分 类 号：R779.6[医药卫生—眼科]