睫状体离断的评估与治疗  

The evaluation and treatment of cyclodialysis clefts

作　　者：邹慧[1] 王晨光[1] 聂黎黎[1] 赵劲松[1] 苏冠方[1] 刘早霞[1] 

机构地区：[1]吉林大学第二医院眼科医院眼底病科,长春130021

出　　处：《中华眼底病杂志》2016年第3期334-338,共5页Chinese Journal of Ocular Fundus Diseases

摘　　要：睫状体离断是一种以低眼压、视力下降为主要表现的少见疾病。通过前房角镜、超声生物显微镜及眼前节光相干断层扫描对睫状体离断进行评估，为治疗方案的选择及疗效评估提供依据。睫状体离断治疗方法主要包括药物、激光光凝、经巩膜透热疗法、睫状体冷冻及睫状体缝合手术等。药物治疗适用于睫状体离断范围小，特别是睫状体与离断区巩膜突附近存在丝状连接者，但目前对于治疗适应证的认识及疗程确定尚未形成共识。虽然激光光凝、经巩膜透热疗法、睫状体冷冻等治疗方法对睫状体离断有一定疗效，但存在损伤较大和复位效果不确定等风险。睫状体缝合手术是目前保守治疗无效的睫状体离断的有效治疗方法，包括外路睫状体缝合、内路睫状体缝合、内窥镜下缝合等。其中，改良的睫状体缝合手术可降低手术风险，疗效确切；但内路睫状体缝合手术和内窥镜下缝合手术对于晶状体需保留者属于禁忌。对于伴有严重眼后节病变的睫状体离断可选择玻璃体切割联合睫状体离断复位手术。The cyclodialysis cleft is a rare disease characterized by ocular hypotony and vision loss. Gonioscopy, ultrasound biomicroscopy and anterior segment optical coherence tomography are used to evaluate the cleft before treatment. The evaluation of cyclodialysis clefts provide a basis for the selection of treatment and the evaluation of effect. Current popular therapeutic approaches for cyclodialysis clefts include medical management, laser photocoagulation, transscleral diathermy, cryotherapy, cyclopexy and so on. Medical treatment is effective in small-size cyclodialysis cleft. But the indications and course of medical treatment remains controversial. Although laser photocoagulation, transscleral diathermy and cryotherapy are effective to treat cyclodialysis clefts in some cases, there are some risks, such as ocular damage, uncertainty about the effect and so on. Cyclopexy is the principal method for cyclodialysis clefts that failed to respond to eonservative management, including extraocular cyclopexy, intraocular cyclopexy and cyclopexy under endoscopie. The modified cyclopexy is effective which reduces the surgical risk. For keeping the lens, intraocular cyelopexy and cyclopexy under endoscopic are not suitable. Vitrectomy combined with other method for cyclodialysis is effective for cyclodialysis clefts which combined with serious posterior segment damage.

关 键 词：睫状体/损伤 睫状体/外科学 综述 

分 类 号：R773.3[医药卫生—眼科]