前房穿刺在急性闭角型青光眼急性发作时的临床应用  

Clinical Application of Anterior Chamber Puncture in Acute Angle-closure Glaucoma

作　　者：魏凌君[1] 郑海涛[1] 

机构地区：[1]周口市中心医院,河南周口466000

出　　处：《中国医药指南》2017年第5期4-5,共2页Guide of China Medicine

摘　　要：目的探讨急性闭角型青光眼急性发作时高眼压持续状态下进行前房穿刺的必要性、可行性。方法对急性闭角型青光眼急性发作患者(40只眼)在常规使用降眼压药物治疗但不能有效降低眼压缓解症状后,使用15°侧穿刀在手术显微镜下进行前房穿刺,然后缓慢放液、前房内注入稀释的毛果芸香碱注射剂0.1 m L,观察眼压以及并发症的发生情况。结果术前眼压均>50 mm Hg,所有患者症状迅速缓解,视力不同程度的提高。3只眼穿刺后5~6 h眼压再次升高,遂再次放液。术后1只眼有轻微前房纤维素性渗出反应,2只眼行小梁切除术后发生Ι°浅前房外,未见其他并发症。结论对于急性闭角型青光眼,特别是药物不能控制眼压的患者,前房穿刺放液+前房内缩瞳剂应用是重要的辅助措施,其损伤小、反应轻、严重并发症发生率低,可以使手术成功率大大提高,且明显降低手术并发症。Objective To explore the feasibility and necessity of anterior chamber puncture, acute angle closure glaucoma with persistent high intraocular pressure during acute condition. Methods The patients with acute attack of acute angle closure glaucoma （40 eyes） glaucoma drug therapy in routine use but can not effectively reduce intraocular pressure relieve symptoms after using the 15 degree side wear the knife under the microscope of anterior chamber puncture drainage, and then slowly, the anterior chamber injection of diluted pilocarpine injection 0.1 mL, intraocular pressure and complications were observed. Results Preoperative intraocular pressure was higher than 50mm Hg, all patients quickly alleviate the symptoms, about 5-6 hours intraocular pressure increased again visual acuity improved.3 eyes after puncture then, once again put the liquid. After 1 eyes had mild fibrous exudation in the anterior chamber reaction, 2 eyes occurred 1 degree of shallow anterior chamber after trabeculectomy, no other complications were found. Conclusion For acute close angle glaucoma, especially drugs fail to control intraocular pressure of patients, anterior chamber paracentesis liquid in anterior chamber miotic application is an important auxiliary measures, little injury, reaction to light, with a low incidence of severe complications can the success rate of operation is improved greatly and decrease the complications.

关 键 词：前房穿刺 急性闭角型青光眼急性发作 临床应用 

分 类 号：R775[医药卫生—眼科]