真性小眼球继发闭角型青光眼多联手术治疗的短期效果分析  

Analysis of short-term effect of combined surgery in the treatment of angle-closure glaucoma secondary to nanophthalmos

作　　者：范昕彤 王嘉健 翟如仪[1,2,3,4] 盛绮练 孔祥梅 FAN Xintong;WANG Jiajian;ZHAI Ruyi;SHENG Qilian;KONG Xiangmei(Department of Ophthalmology,Eye&ENT Hospital,Fudan University,Shanghai 200031,China;NHC Key Laboratory of Myopia(Fudan University),Shanghai 200031,China;Key Laboratory of Myopia,Chinese Academy of Medical Sciences,Shanghai 200031,China;Shanghai Key Laboratory of Visual Impairment and Restoration,Shanghai 200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院眼科,上海200031 [2]国家卫生健康委员会近视眼重点实验室(复旦大学),上海200031 [3]中国医学科学院近视眼重点实验室,上海200031 [4]上海市视觉损害与重建重点实验室,上海200031

出　　处：《中国眼耳鼻喉科杂志》2022年第2期137-143,149,共8页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：国家自然科学基金(81770922);上海市科学技术委员会项目(19411961600、201409006600);复旦大学附属眼耳鼻喉科医院双优双值项目(SYB202003);上海市卫生和计划生育委员会科研课题(201740204);上海申康医院发展中心临床研究培育项目(SHDC12017X18)。

摘　　要：目的研究多联手术治疗真性小眼球继发闭角型青光眼的疗效及安全性。方法回顾收集了16例(18眼)真性小眼球继发闭角型青光眼行“巩膜板层切除+超声乳化晶状体吸除+房角分离+前段玻璃体切除”多联手术的患者,随访并观察患者术后眼压、最佳矫正视力(BCVA)及手术相关并发症等情况。结果患者术后眼压显著降低(P<0.001)。术后随访有2例患者出现眼压再升高,经药物治疗后眼压下降且维持于正常水平,其余患者术后眼压均正常。总体患者的术后短期BCVA有所提高,但差异没有统计学意义;慢性闭角型青光眼患者的术后视力显著提高(P=0.035)。有1例患者于术中发生了脉络膜上腔出血;其余8例(44.4%)术后出现并发症的患者,短期内均恢复良好。结论多联手术治疗真性小眼球继发青光眼的患者,眼压控制效果较好,手术安全性较高,术后短期内发生严重并发症的风险较低。Objective To investigate the efficacy and safety of combined surgery in the treatment of secondary angle-closure glaucoma in nanophthalmos.Methods Sixteen patients(18 eyes)with nanophthalmos secondary to angle-closure glaucoma who had undergone“sclerectomy+phacoemulsification+goniosynechialysis+anterior vitrectomy”combined surgery were collected retrospectively.Postoperative intraocular pressure(IOP),best corrected visual acuity(BCVA)and surgical complications were followed up and recorded.Results Postoperative IOP was significantly reduced in all patients(P<0.001).Though it rose again in 2 patients,however,both of them got well controlled with topical medication treatment.All other patients had normal and stable IOP after surgery.Postoperative short-term BCVA was improved generally,but the difference was not statistically significant.In patients with chronic angle-closure glaucoma,postoperative BCVA was significantly improved(P=0.035).Intraoperative suprachoroidal hemorrhage occurred in 1 patient.Eight cases(44.4%)with postoperative complications recovered well in a short time.Conclusions Combined surgery has a beneficial effect on the control of IOP in patients with secondary glaucoma of nanophthalmos,with relatively higher safety and lower risk of severe postoperative complications in a short term.

关 键 词：真性小眼球 闭角型青光眼 继发性青光眼 抗青光眼手术 多联手术 治疗效果 术后并发症 

分 类 号：R779.6[医药卫生—眼科]