虹膜周边前后节沟通术治疗恶性青光眼及具有恶性青光眼倾向的原发性闭角型青光眼  

Iris peripheral anterior and posterior segment communication for malignant glaucoma and primary angle-closure glaucoma with malignant glaucoma tendency

作　　者：党江波 周美娇 李钢锋 DANG Jiang-bo;ZHOU Mei-jiao;LI Gang-feng(Department of Ophthalmology,Yulin Hospital of Traditional Chinese Medicine,Yulin Shaanxi 719000,China;Department of Ophthalmology,Yangling Demonstration Area Hospital,Xianyang Shaanxi 712100,China)

机构地区：[1]榆林市中医医院眼科,陕西榆林719000 [2]杨凌示范区医院眼科,陕西咸阳712100

出　　处：《临床和实验医学杂志》2023年第4期418-421,共4页Journal of Clinical and Experimental Medicine

基　　金：陕西省重点研究科研项目(编号:2019SF-179)。

摘　　要：目的探讨虹膜周边前后节沟通术治疗原发性闭角型青光眼(具有恶性青光眼倾向)及恶性青光眼的临床效果。方法回顾性选取2020年2月至2022年2月榆林市中医医院眼科原发性闭角型青光眼(具有恶性青光眼倾向)及恶性青光眼患者100例(100眼),依据手术方法分为新型虹膜周边前后节沟通术组(新型手术组)、传统超声乳化吸出加人工晶状体植入加后囊切开加前部玻璃体切割术组(传统手术组)两组,各50例(50眼)。统计分析两组患者的眼压、最佳矫正视力、视野、视神经功能、中央前房深度、临床疗效、浅前房分度、泪膜功能、生活自理能力、睡眠情况、并发症发生情况及患者满意度。结果新型手术组患者的眼压、最佳矫正视力、图形视觉诱发电位(P-VEP)潜伏期为(13.15±2.54)mmHg、(0.61±0.10)logMAR、108.43±9.56,均明显低于传统手术组[(23.56±3.58)mmHg、(0.83±0.11)logMAR、119.60±9.25],平均光敏度、P-VEP振幅、中央前房深度为28.04±4.82、8.00±0.70、(3.33±0.36)mm,均明显高于传统手术组[24.24±4.26、4.95±0.60、(2.51±0.41)mm],差异均有统计学意义(P<0.05)。新型手术组患者的总有效率为92.00%,明显高于传统手术组(56.00%),差异有统计学意义(P<0.05)。新型手术组患者的浅前房分度发生率为20.00%,明显低于传统手术组(68.00%),差异有统计学意义(P<0.05)。新型手术组患者的视盘面积/视杯面积(C/D)、角膜荧光素染色(FSC)为0.34±0.03、(1.02±0.30)分,均明显低于传统手术组[0.39±0.03、(1.75±0.25)分],前房深度、泪膜破裂时间、Shirmer I试验(2.08±0.17)mm、(15.85±2.04)s、(14.62±2.47)mm,均明显高于传统手术组(1.80±0.16)mm、(12.32±2.12)s、(12.12±2.32)mm,差异均有统计学意义(P<0.05),但两组患者的眼轴长度之间的差异无统计学意义(P>0.05)。新型手术组患者的生活自理能力强比率为74.00%,明显高于传统手术组(44.00%),睡眠好比率为76.00%,明显Objective To investigate the clinical effect of periiris anterior and posterior segment communication in the treatment of primary angle-closure glaucoma(with malignant glaucoma tendency)and malignant glaucoma.Methods A total of 100 patients(100 eyes)with primary angle-closure glaucoma(with malignant glaucoma tendency)and malignant glaucoma in Department of Ophthalmology,Yulin Hospital of Traditional Chinese Medicine from February 2020 to February 2022 were retrospectively selected.According to the surgical method,the patients were divided into two groups:the new anterior and posterior segment communication around the iris group(the new operation group)and the traditional phacoemulsification and intraocular lens implantation plus posterior capsulectomy and anterior vitrectomy group(the traditional operation group),50 cases(50 eyes)in each group.The intraocular pressure,best corrected visual acuity,visual field,optic nerve function,central anterior chamber depth,clinical efficacy,shallow anterior chamber score,tear film function,self-care ability,sleep,complications and satisfaction were statistically analyzed between the two groups.Results The intraocular pressure,best corrected visual acuity and pattern visual evoked potential(P-VEP)latency of patients in the new surgery group were(13.15±2.54)mmHg,(0.61±0.10)logMAR,108.43±9.56,which were lower than those in the traditional surgery group[(23.56±3.58)mmHg,(0.83±0.11)logMAR,119.60±9.25],and the average light sensitivity,P-VEP amplitude and central anterior chamber depth were 28.04±4.82,8.00±0.70,(3.33±0.36)mm,which were higher than those in the traditional surgery group[24.24±4.26,4.95±0.60,(2.51±0.41)mm],the differences were statistically significant(P<0.05).The total effective rate of the new surgery group was 92.00%,which was higher than that of the traditional surgery group(56.00%),the difference was statistically significant(P<0.05).The incidence of shallow anterior chamber fractionation in the new surgery group was 20.00%,which was lower than that

关 键 词：恶性青光眼 具有恶性青光眼倾向 原发性闭角型青光眼 虹膜周边前后节沟通术 眼压 最佳矫正视力 并发症 

分 类 号：R779.6[医药卫生—眼科]