小梁切除术后白内障患者行超声乳化白内障吸除术致眼压失控的临床分析  

Clinical analysis of acute intraocular hypertension after phacoemulsification with previous trabeculectomy

作　　者：梁亚 袁志兰 牟朝霞 孙红 Liang Ya;Yuan Zilan;Mu Zhaoxia;Sun Hong(Department of Ophthalmology,Jiangsu Province Hospital,Nanfing,Jiangsu 210029,China)

机构地区：[1]江苏省人民医院南京医科大学第一附属医院眼科,210029

出　　处：《临床眼科杂志》2018年第5期397-400,共4页Journal of Clinical Ophthalmology

基　　金：国家自然科学基金面上项目(编号81271001)

摘　　要：目的研究分析小梁切除术后白内障患者行超声乳化白内障吸除术后致眼压失控患者的临床特征、相关因素以及治疗效果,并分析其防治策略。方法回顾性分析2010年2月至2017年2月于江苏省人民医院眼科就诊的小梁切除术后白内障患者行超声乳化白内障吸除术致其眼压失控的全部患者,共11例(11只眼)。进行相关因素分析,总结临床特点,并对治疗结果进行观察。结果小梁切除术后白内障患者行超声乳化白内障吸除术致其眼压失控的患者发生率为9. 75%,多为薄壁囊样型滤过泡,药物治疗均不能控制眼压。8例患者行小梁切除术,6例患者行滤泡分离术(包括3例小梁切除术失败患者)。再次小梁切除术的完全成功率为50%,滤过泡分离成功率达到100%,滤过泡分离术后能够显著恢复原有滤过泡的形态,增加滤过。结论小梁切除术后白内障患者行超声乳化白内障吸除术可能导致眼压失控,术前应做好评估,术中做好防范,术后加强监控。滤过泡分离术能够安全有效的恢复原有滤过泡功能并降低眼压。Objecive To study the treatment effect of acute intraocular hypertension after phacoemulsification with previous trabeculectomy and to analyze its management.Methods A retrospective analysis of 11 cases （11 eyes） of all patients with acute elevated intraocular pressure （IOP） caused by phacoemulsification after trabeculectomy from February 2010 to February 2017 in Jiangsu Province Hospital. The related factors were analyzed, the clinical characteristics were summarized, and the treatment results were observed.Results The incidence of uncontrolled IOP induced by phacoemulsification in cataract patients after trabeculectomy was 9.75%, mostly with thin-walled cystic filtered bleb. Medications were unable to control the IOP. 8 patients underwent trabeculectomy and 6 patients underwent filtered bleb separation （including 3 patients with trabeculectomy failure）. The complete success rate of the second trabeculectomy was 50%. The success rate of filtered bleb separation reached 100%.Conclusions Phacoemulsification with previous trabeculectomy resulted in an acute increase in IOP. Filtered bleb separation were effective and safe in restoring filtered bleb function and reducing IOP.

关 键 词：白内障超声乳化吸除术 小梁切除术 滤过 眼压 

分 类 号：R779.6[医药卫生—眼科]