睫状环阻滞性青光眼的阶梯治疗临床分析  

Clinical analysis of ladder treatment in ciliary block glaucoma

作　　者：王宇冉[1] 孔晓路[1] 靳中良[1] 孙利娜[1] 侯习武[1] 苗青[1] 

机构地区：[1]郑州大学第四附属医院眼科,河南省眼科医院,河南省郑州市450054

出　　处：《眼科新进展》2014年第11期1065-1068,共4页Recent Advances in Ophthalmology

摘　　要：目的探讨睫状环阻滞性青光眼的临床治疗方法及效果分析。方法回顾性分析2006年3月至2013年6月经我院治疗的14眼睫状环阻滞性青光眼的临床资料,首先采用药物治疗,治疗无效者及时手术治疗。手术方法：抽吸玻璃体水囊联合前房重建术4例4眼;前段玻璃体切割联合白内障超声乳化联合人工晶状体植入联合局部后囊切开术（对于人工晶状体眼采取晶状体后囊切开联合前部玻璃体切割术）4例4眼。结果经药物治疗后,6眼病情得到缓解,4眼在药物治疗的同时行玻璃体内水囊抽吸联合前房重建术;4眼在上述治疗无效基础上进一步手术治疗,其中3眼行前段玻璃体切割联合白内障超声乳化联合人工晶状体植入联合局部后囊切开术,另1眼为白内障术后患者,行后囊切开联合前部玻璃体切割术。术后随访3～6个月,术后眼压（16.378±4.308）mmHg（1 kPa=7.5 mmHg）,与术前（36.539±2.739）mmHg差异有统计学意义（P〈0.05）;术后前房深度全部恢复正常且稳定（2.423±0.379）mm,与术前（0.613±0.185）mm差异有统计学意义（P〈0.05）。结论对于术后发生的睫状环阻滞性青光眼,采取由简单到复杂的阶梯式治疗,能够取得较好的临床疗效。Objective To investigate the clinical treatment and effect of ciliary block glaucoma. Methods A retrospective analysis of clinical data from March 2006 to June 2013 in our hospital were performed in 14 eyes with ciliary block glaucoma,the drug therapy was first used,or timely operation treatment when drug weren＇t effective. Operation methods： Aspiration of vitreous water bag associate with anterior reconstruction in 4 eyes; The anterior vitrectomy combined with phacoemulsification and intraocular lens implantation combined with partial capsulotomy（ for artificial crystal eyes taking posterior capsular incision combined with anterior vitrectomy） in 4 eyes.Results The diseases got alleviation after drug treatment in 6 eye,aspiration of vitreous water bag associate with anterior reconstruction were adopted at the same time with the drug treatment in 4 eyes; Further surgery in 4 eyes were adopted when the above treatment was invalid,of which3 eyes had the anterior vitrectomy combined with phacoemulsification and intraocular lens implantation combined with partial capsulotomy,the other one had the anterior vitrectomy combined with capsulotomy. the patients were followed up from 3 months to 6 months,the preoperative and postoperative intraocular pressure were（ 36. 539 ± 2. 739） mmHg（ 1 kPa = 7. 5 mmHg） and（ 16. 378± 4. 308） mmHg,there was statistical difference（ P〈0. 05）. The preoperative and postoperative anterior chamber depth were（ 0. 613 ± 0. 185） mm and（ 2. 423 ± 0. 379） mm,there was statistical difference（ P〈0. 05）. Conclusion The escalation therapy from simple to complex for the ciliary block glaucoma after operation can achieve the better clinical effects.

关 键 词：睫状环阻滞性青光眼 药物治疗 手术 

分 类 号：R775[医药卫生—眼科]