高眼压下PACG小梁切除术的临床分析

Clinical analysis of trabeculectomy for primary acute angle-closure glaucoma with high intraocular pressure

摘要:

目的：探讨在高眼压状态下进行小梁切除治疗原发性急性闭角型青光眼（PACG）的手术特点。观察手术的安全性和治疗效果。 方法：回顾性分析小梁切除术治疗48例50眼PACG，按手术前用药下的眼压情况分为治疗组（12眼，眼压≥40mmHg，1mmHg=0.133kPa）和对照组（38眼，眼压＜40mmHg），并对两组术前术后的眼压、视力、手术并发症和成功率进行比较。 结果：两组病例术中术后均未出现暴发性脉络膜出血、恶性青光眼等严重并发症。术后早期手术成功率对照组明显高于治疗组，差异有统计学意义（P=0.0332），但后期两组成功率差异无统计学意义（P＞0.05）。 结论：对持续高眼压状态下PACG，为避免视功能的进一步损害，可早期行小梁切除术。

Abstract:

AIM:To evaluate the therapeutic efficacy and safety of trabeculectomy for primary acute angle-closure glaucoma(PACG) with high intraocular pressure (IOP)． METHODS:Fourty-eight cases (50 eyes) of PACG were retrospectively analyzed，which underwent trabeculectomy. These cases were divided into 2 groups by the preoperative IOP： the operation group (12 eyes，IOP≥40mmHg)，and the control group (38 eyes，IOP＜40mmHg)．The IOP，visual acuity，complications and surgery outcome of both groups were compared． RESULTS: No severe complications such as choroidal hemorrhage，malignant glaucoma were observed in both groups during surgery and postoperation．The success rate of operation in the control group was much higher than that in the operation group shortly after the operation with significant difference (P=0.0332）．But the success rate of both groups had no significant difference（P＞0.05）in return visit． CONCLUSION:Trabeculectomy for PACG with persistent high IOP should be performed actively to avoid further damage to the visual function．