睫状环阻塞性青光眼的临床治疗  

The treatment for ciliary block glaucoma

作　　者：梁伟亮[1] 黄泳瑜[1] 关仕嫦[1] 关卫文[1] 余超明[1] 谭劲光[1] 胡小玲[1] 

机构地区：[1]开平市中心医院眼科,广东529300

出　　处：《中华眼外伤职业眼病杂志》2016年第11期859-862,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的：探讨睫状环阻塞性青光眼药物及手术治疗的效果。方法2010年1月至2013年9月在我院治疗的睫状环阻塞性青光眼7例（8眼）。回顾性分析其治疗方案、治疗前后视力、眼压、前房情况。结果7例（8眼）中手术治疗5例（6眼）,其中2例（3眼）行晶状体超声乳化＋人工晶状体植入＋晶状体后囊圆形撕囊＋前段玻璃体切除术；1例（1眼）合并晶状体半脱位,术中植入囊袋张力环；1例（1眼）人工晶状体眼行晶状体后囊圆形撕囊＋前段玻璃体切除术；1例（1眼）行前段玻璃体切除＋晶状体囊内摘出术,未植入人工晶体。手术治疗者术后眼压控制良好,均未见复发。2例（2眼）进行以睫状肌麻痹剂、碳酸酐酶抑制剂及糖皮质激素滴眼液滴眼为主的综合药物治疗,其中1例药物治疗持续半年,眼压稳定,随诊3.5年,无复发；另1例每停药1周即复发,1年内复发9次。结论以睫状肌麻痹剂及糖皮质激素滴眼液为主的综合药物治疗能缓解部分早期睫状环阻塞性青光眼,但易复发,需长期持续用药；晶状体超声乳化＋人工晶状体植入＋晶状体后囊圆形撕囊＋前段玻璃体切除术是一种治疗睫状环阻塞性青光眼的安全、有效的方法。早期及时手术治疗有利于视功能的保存。Objective To investigate the efficacy of medical and surgical treatment for ciliary block glaucoma. Methods Eight eyes of 7 patients of ciliary block glaucima in our hospital from January 2010 to September 2013 were enrolled in the retrospective study. The effects of medical and surgical treatment, preoperative and postoperative visual acuity（ VA）、intraocular pressure（ IOP） and depth of anterior chamber were evaluated and analyzed. Results Six eyes of 5 cases received surgical treatment. Among 5 cases, 3 eyes of 2 patients were treated by phacoemulsification combined with intraocular lens implantation、posterior continuous curvilinear capsulorhexis （ PCCC ） and anterior vitrectomy （ AV ） . One pseudophakic eye underwent PCCC and AV. One eye received intracapsular cataract extraction （ ICCE ） and AV without implantation of instraocular lens . The capsular tension ring was used in one case which complicated with lens subluxation. There was no recurrence of ciliary block glaucoma in patients after surgical treatment. The IOP was controlled well. Two eyes of two patients were treated with comprehensive medication, which included local cycloplegic, carbonic anhydrase inhibitor and glucocorticoid eyedrops. Of these two cases,one eye was cured with medication lasted for half an year and followed up 3. 5 years;the other recurred 9 times in one year which recurred every time when stopping medication for one week. Conclusion Local cycloplegic and glucocorticoid, as the main medication of comprehensive treatment, in treatment of early ciliary block glaucoma partially, but easy to recur. Compared with medication treatment, phacoemulsification combined with intraocular lens implantation, PCCC and AV for the treatment of ciliary block glaucoma is a safe and effective method. Early and timely treatment is beneficial to the preservation of visual function.

关 键 词：青光眼 睫状环阻塞性 治疗 前部玻璃体切除术 晶状体超声乳化术 晶状体后囊撕囊术 

分 类 号：R775[医药卫生—眼科]