多联手术治疗真性小眼球继发闭角型青光眼的疗效  

Observation of the Curative Effect of Multi-Model Operations in the Treatment of Secondary Angle-Closure Glaucoma of Small True Eyebal

作　　者：姚鹏 吕静怡[1] 杨惠婷 YAO Peng;LYU Jingyi;YANG Huiting(Department of Glaucoma,Ideal Eye Hospital,Soochow University,Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州大学理想眼科医院青光眼科,江苏苏州215000

出　　处：《中国医药指南》2025年第7期26-30,共5页Guide of China Medicine

摘　　要：目的 观察多联手术用于治疗真性小眼球继发闭角型青光眼的有效性和安全性。方法 回顾收集2021年1月至2023年8月于苏州大学理想眼科医院7例(11眼)真性小眼球继发闭角型青光眼患者经二联手术白内障超声乳化联合人工晶体植入+直视下房角分离;三联手术白内障超声乳化联合人工晶体植入+前部玻璃体切除+直视下房角分离;四联手术巩膜开窗术+前部玻璃体切除+白内障超声乳化联合人工晶体植入+直视下房角分离或引流阀植入治疗的患者,随访并记录患者术后视力、眼压及并发症发生情况等。结果 所有患者术后眼压均得到有效控制,术后有3例患者分别使用1种或2种药物控制眼压,余均未使用药物而眼压正常;有3例(5眼)术后视力较术前提高,余患者视力与术前无差异;术前睫状体脱离2例,脉络膜脱离1例;术后脉络膜脱离4例,有3例发生在术后1周内,1例发生在术后1个月后,4例见于未联合巩膜开窗患者,经激素等药物治疗均自愈。结论真性小眼球继发闭角型青光眼治疗相对复杂,易出现并发症,依据患者具体情况制订多联手术方案,可有效降低患者眼压。Objective To observe the efficacy and safety of multi-model surgeries in the treatment of secondary angle-closure glaucoma of small true eyeball.Methods A retrospective study of 7 patients(11 eyes)with secondary angle-closure glaucoma of small true eyeballs was conducted at the Ideal Eye Hospital,Soochow University,Suzhou,from January 2021 to August 2023.Patients were randomly assigned to two treatment modalities:three-model surgery and four-model surgery.The three-model surgery involved cataract phacoemulsification and intraocular lens implantation,anterior vitrectomy,and direct eye angle separation.The four-model surgery included scleral fenestration,anterior vitrectomy,cataract phacoemulsification and intraocular lens implantation,as well as direct eye angle separation or drainage valve implantation.Postoperative data collected included visual acuity,intraocular pressure(IOP),and complications.Results The intraocular pressure was effectively controlled in all patients.Following the surgery,three patients required one or two medications to manage their intraocular pressure(IOP),while the rest of the patients did not need any medication for IOP control.The visual acuity of 3 patients(5 eyes)was improved after operation,and the visual acuity of the remaining patients was not different from that before operation.Prior to surgery,2 patients had ciliary detachment and 1 patient had choroidal detachment.Postoperatively,additional 3 patients developed choroidal detachment,making a total of 4 cases.Specifically,3 of these cases emerged within one week after the surgery,and the remaining 1 case occurred one month later.Notably,all 4 cases of choroidal detachment occurred in patients who did not undergo scleral fenestration.All these cases were successfully resolved with the administration of hormones and other medications.Conclusions The treatment of secondary angleclosure glaucoma with true small eyeball is relatively complicated,and complications are easy to occur.Based on the specific conditions of patients,the devel

关 键 词：真性小眼球 青光眼 多联手术 

分 类 号：R775.3[医药卫生—眼科]