玻璃体切割术后(水眼)继发青光眼的手术治疗策略  

Surgical strategies for glaucoma secondary to vitrectomy

作　　者：高郁玮[1] 张舒心[2] 孙丽[2] 张馨方[1] 

机构地区：[1]北京华德眼科医院,北京市100026 [2]首都医科大学附属北京同仁医院眼科,北京市100005

出　　处：《眼科新进展》2016年第3期254-256,共3页Recent Advances in Ophthalmology

摘　　要：目的评估玻璃体切割术后(水眼)继发青光眼患者的手术治疗方法。方法回顾性分析我院2013年10月至2014年4月收治的玻璃体切割术后(水眼)继发青光眼患者26例26眼的临床资料,对所有患者进行复合式小梁切除术,术中采用预置缝线,术后随访12个月,观察视力、眼压及并发症情况。结果末次随访时,视力、眼压均较术前改善,差异均有统计学意义(均为P<0.05);20眼获得了满意效果,6眼术后眼压回升,加用降眼压药物后4眼控制在正常范围,2眼眼压失控,再次行睫状体二极管光凝术,术后眼压正常。结论复合式小梁切除术,术中采用预置缝线,对玻璃体切割术后(水眼)继发青光眼患者是一种安全有效的手术方式,可以在很大程度上减少术中暴发性脉络膜出血及术后脉络膜脱离的发生几率。Objective To evaluate the surgical strategies for glaucoma secondary to vitrectomy. Methods A retrospective reviewwas performed in 26 patients（26 eyes） with glaucoma secondary to vitrectomy in our hospital from October 2013 to April 2014,all cases underwent the combined trabeculectomy. Intraoperative preset suture was used in all of the patients. The follow-up time was 12 months,the visual acuity,intraocular pressure（IOP） and complications were observed. Results At the final follow-up,the visual acuity and IOP were improved,there were statistical differences compared with pre-operation（all P 〈 0. 05）; The surgical effects in 20 eyes were satisfactory,the postoperative IOP in 6 eyes increased,the decreased IOP drugs were given,then IOP in 4 eyes were returned to normal,another 2 eyes were uncontrolled to perform the ciliary body diode photocoagulation,and the postoperative IOP were returned to normal. Conclusion Combined trabeculectomy with intraoperative preset suture is effective in treating glaucoma secondary to vitrectomy,can largely reduce the incidence of intraoperative explosive choroid bleeding and postoperative choroid detachment.

关 键 词：玻璃体切割术后 继发青光眼 复合式小梁切除术 

分 类 号：R775.3[医药卫生—眼科]