悬韧带松弛继发急性闭角型青光眼1例  

Acute angle-closure glaucoma secondary to suspensory ligament relaxation:a case report

作　　者：王龙龙 WANG Longlong

机构地区：[1]亳州市中医院,安徽亳州236800

出　　处：《中医临床研究》2022年第3期93-95,共3页Clinical Journal Of Chinese Medicine

摘　　要：晶状体作为眼内屈光介质的重要组成部分,其赤道部周围附着悬韧带,通过睫状肌的收缩与放松共同完成晶状体厚度的调节。晶状体悬韧带的异常可继发多种眼部疾病,其中以继发青光眼居多,临床表现与原发性急性闭角型青光眼相似。其主要发病机制为:晶状体悬韧带松弛使得晶体位置稳定性降低,通过前倾身躯、低头或处于俯卧状态时等机制使晶状体前移可阻滞瞳孔,由于晶状体虹膜隔前移,继而前房变浅、房角关闭,从而导致急性青光眼的发作。对于此类患者,若给予缩瞳等常规的急性闭角型青光眼的处理方法,不仅不能起到降低眼压的作用,反而会使症状进一步加重。对于悬韧带松弛继发青光眼的治疗,主要为手术摘除晶状体并根据患者情况制订个体化手术治疗。研究表明,对于本病的治疗在手术前以中西结合为宜,术后以中医治疗为主。我科收治一例悬韧带松弛继发急性闭角型青光眼的患者,经中西医结合抗青光眼治疗后,症状明显改善,现报道如下。The lens is an important part of the intraocular refractive medium.And the suspensory ligament is attached around the equator,and the lens thickness is adjusted by the contraction and relaxation of the ciliary muscle.Abnormal lens suspensory ligament can cause a variety of eye diseases,of which secondary glaucoma is the majority,and its clinical manifestations are similar to primary acute angle-closure glaucoma.The main pathogenesis is that the loosening of the lens suspensory ligament reduces the stability of the lens position,and the lens can block the pupil by leaning the body forward,lowering the head or lying prone.Then the anterior chamber becomes shallow and the angle of the chamber closes,which leads to the onset of acute glaucoma.For such patients,if the conventional methods of treatment of acute angle-closure glaucoma such as miotics are given,it can not reduce the intraocular pressure,but it will further aggravate the symptoms.For the treatment of glaucoma secondary to suspensory ligament relaxation,the main operation is to remove the lens and make individualized surgical treatment according to the patient’s condition.Studies have shown that the treatment of this disease should be based on the combination of Chinese and Western medicine before surgery,and taking traditional Chinese medicine after surgery.A case of acute angle-closure glaucoma secondary to suspensory ligament relaxation was admitted to our department.After anti-glaucoma treatment with integrated Chinese and Western medicine,the symptoms were significantly relieved.The report is as follows.

关 键 词：晶状体悬韧带 急性闭角型青光眼 抗青光眼手术 中西医结合 

分 类 号：R775.2[医药卫生—眼科]