前房穿刺术在急性闭角型青光眼高眼压持续状态下的应用

Application of anterior chamber penetration in acute angle-closure glaucoma with continuous high intraocular pressure

摘要:

目的:研究前房穿刺术处理青光眼高眼压持续状态下的疗效。方法:急性闭角型青光眼病例80例80眼按手术前处理方法分为前房穿刺组(40例40眼)和药物治疗对照组(40例40眼),治疗前眼压均≥50mmHg,对两组病例治疗后视力、眼压、房角开放情况以及手术并发症情况进行统计比较。结果:两组病例治疗后大多数保留了较好的视力;两组病例治疗后眼压均下降,对照组下降幅度小于前房穿刺组;房角镜检查,前房穿刺组房角重新开放病例多于对照组;抗青光眼手术后前房穿刺组无明显并发症,对照组1例发生恶性青光眼,3例发生睫状体脱离,4例发生Ⅱ°浅前房。结论:前房穿刺术治疗急性闭角型青光眼高眼压持续状态是安全、有效的,操作简便,减轻因高眼压造成的视功能损害,为青光眼的进一步治疗创造了条件。

Abstract:

AIM:To investigate clinical effects of anterior chamber penetration on treating the glaucoma with continuous high intraocular pressure (IOP). METHODS: Eighty cases (80 eyes) of primary acute angle-closure glaucoma were divided into two groups by the different methods of treatment, anterior chamber penetration group: 40 cases (40 eyes) and control group: 40 cases (40 eyes). All the cases had IOP≥50mmHg before treatment. Before and after the treatment, routine examinations such as best spectacle corrected visual acuity(BSCVA),IOP were performed, the changes in anterior chamber angle and the complications of the surgery were observed and analyzed by SPSS statistically.RESULTS: Most cases gained a better vision after the treatment. The IOP of both groups were reduced, and the anterior chamber penetration group was lower than the control group. In gonioscopy examination, the higher ratio of the anterior chamber angle reopening was found in the anterior chamber penetration group. After the filtrating surgery, there were no complications in the anterior chamber penetration group. In the control group, malignant glaucoma were observed in 1 case, cyclodialysis was observed in 3 cases and shallow of anterior chamber was observed in 4 cases.CONCLUSION: Anterior chamber penetration is one kind of safe, effective and simple method of treating the glaucoma with continuous high IOP. It can reduce the damage to visual function caused by the high IOP and provide the good condition before the surgery. 