急性闭角型青光眼持续高眼压的手术治疗

    Surgery of acute angle-closure glaucoma with continuous high intraocular pressure

    • 摘要: 目的:探讨持续高眼压状态下急性闭角型青光眼手术治疗的方法和疗效。方法:对使用多种药物3天不能控制眼压(40 mmHg)的56例(56眼)患者施行小梁切除术。术前尽量降低眼压,术中少量、缓慢、多次释放房水,使用可调整缝线,术后恢复前房防止眼压过低。结果:未出现脉络膜上腔爆发性出血和恶性青光眼。术后患眼视力0.01~0.1 16眼,;0.1~0.8 40眼,均好于术前高眼压状态下视力(P;0.01)。术后眼压21 mmHg 48眼。较术前明显降低(P;0.01)。术后3例脉络膜脱离,2例滤过过强致前房迟缓形成,2例滤过不畅致高眼压,均经过治疗后恢复。结论:持续高眼压急诊行小梁切除术是可行而且必要的。

       

      Abstract: Objective:To explore the method and clinical effect of trabeculectomy for acute angle-closure glaucoma(ACG) with continuous high intraocular pressure(IOP).Methods:Fifty-six patients(56 eyes) were accepted trabeculectomy whose IOP were continuously over 40 mmHg after use of repressive pressure medicine more than 3 days,including dropping IOP before surgery,releasing aqueous humor slowly and repetitiously,using releasable suture and injecting blind source separation to renew the anterior chamber depth.Results:There were no serious complications such as suprachoroidal space bleeding and malignant glaucoma.The vision was between 0.01-0.1 in 16 eyes,0.1-0.8 in 40 eyes.Most of the cases had better vision than before(P0.01).The post-operative IOP was 21 mmHg in 48 eyes,which was significantly lower than before surgery(P0.01).Choroidal detachment was occurred in 3 eyes,delayed anterior chamber reformation for strong filteration in 2 eyes,and high IOP for low filteration in 2 eyes.Conclusions:It is necessary and safety to do trabeculectomy for ACG with continuous high state of IOP.

       

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