前房穿刺联合黏弹剂在青光眼持续高眼压中的临床应用

Paracentesis of anterior chamber with Healon agent in glaucoma with persistent high intraocular pressure

摘要:

目的:探讨前房穿刺联合黏弹剂在青光眼持续高眼压中应用的安全性和可行性。方法:对32例34眼眼压控制不良的青光眼患者进行了术前、术中前房穿刺,术中联合应用黏弹剂,观察术后视力和眼压,以及术中、术后并发症的情况。结果:所有病例手术过程顺利,无1例出现驱逐性脉络膜出血,1例前房出血经治疗后很快吸收,1例发生恶性青光眼转上级医院治疗。术后1mo视力较术前提高者18眼,占53%;视力不变者10眼,占29%;视力下降者6眼,占18%;术后1mo共30眼眼压控制理想,占88%,1眼发生恶性青光眼已转院,3眼眼压>21mmHg,经药物治疗、局部按摩,手术1mo后此3眼中有2眼眼压逐渐降至正常。结论:前房穿刺联合黏弹剂在青光眼持续高眼压中应用,可以减轻手术并发症,提高手术成功率。

Abstract:

AIM:To explore the safety,feasibility of paracentesis with Healon agent in glaucoma with persistent high intraocular pressure(IOP).METHODS:A total of 32 cases(34 eyes) of IOP controlled bad of glaucoma underwent intraoperative and preoperative anterior chamber puncture combined with intraoperative application of Healon agent.Visual acuity,IOP,intraoperative and postoperative complications were observed.RESULTS:The operation in all cases were successful and no case occurred with the fulminant hemorrhage in choroidal space.1 case occurred with anterior chamber bleeding,which was absorbed very quickly after therapy,1 case occurred with malignant glaucoma who turned to superior hospital treatment.The visual acuity in a month after operation improved obviously in 18 eyes(53%),remained unchanged in 10 eyes(29%)and decreased in 6 eyes(18%).In a month after operation,there were 30 eyes(88%)in which the IOP was controlled successfully.Three eyes had IOP over 21mmHg,of which 2 eyes were controlled in a month after operation by drugs and local massage.CONCLUSION:The paracentesis of anterior chamber with Healon agent in glaucoma with persistent high IOP can reduce the complications and improve the success rate.