后房玻璃体中央管穿刺联合虹膜环切治疗瞳孔闭锁继发青光眼  

Vitreous cloquet paracentesis combined with circular iridectomy for glaucoma secondary to pupillary seclusion

作　　者：袁久民[1] 潘庆敏[1] 李凤芹 赵斌[1] 王艺[1] 

机构地区：[1]泰山医学院附属医院眼科,山东泰安271000 [2]新泰市第三人民医院眼科

出　　处：《中华眼外伤职业眼病杂志》2013年第3期220-224,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨由瞳孔膜闭、瞳孔闭锁引起的继发性青光眼的手术方法。方法103例（105眼）由瞳孔膜闭、瞳孔闭锁引起的，经强力散瞳、降压、抗炎等药物治疗病情不能得到根本好转的继发性青光眼作为手术对象（角膜变性、虹膜重度萎缩或三期新生血管者除外），施行后房玻璃体中央管穿刺、虹膜前房角黏弹剂分离、虹膜部分环切等多联手术治疗。结果103例（105眼）术后眼压均得到控制。瞳孔均呈居中圆形或接近居中圆形，自然直径2．5—5．0mm。视力提高94眼，无变化11眼。无脉络膜下爆发性出血等严重并发症发生。结论对于由瞳孔膜闭、瞳孔闭锁引起的继发性青光眼，行后房玻璃体中央管穿刺、虹膜房角黏弹剂分离、虹膜部分环切等多联手术是一种有效的手术方法。Objective To investigate the surgical techniques for the treatment of glaucoma second- ary to occlusion or seclusion of pupil. Methods The paracentesis of posterior chamber and vitreous clo- quet＇ s canal , separating the iris from anterior chamber angle with viscoelastic substance, partial circular ir- idectomy were performed on 105 eyes of 103 cases with glaucoma secondary to occlusion or seclusion of pu- pil, whose condition could not be improved effectively with conventional drug treatment. Cases with corneal degeneration, severe atrophy of iris or stage ill iris neovascularization were excluded. Results The intraocular pressure （IOP） was normal in 105 eyes of 103 cases. A physiological round or near-round pupil （2.5 mm - 5.0 mm） was acquired. The visual acuity was improved in 94 eyes of 92 cases; the visual acuity has no change in 11 eyes of 11 cases. There were no serious complications. Conclusion The combination of the surgical techniques of vitreous cloquet paracentesis, anterior chamber angle separation and circular iridectomy is a safe and effective method for glaucoma secondary to occlusion or seclusion of pupil.

关 键 词：瞳孔闭锁 瞳孔膜闭 青光眼 继发性 手术 

分 类 号：R779.6[医药卫生—眼科]