目的：观察应用25G+微创玻璃体手术治疗人工晶状体植入术后恶性青光眼的临床效果。

方法：回顾性分析2013-01/2016-07在我科就诊的人工晶状体植入术后恶性青光眼确诊患者18例18眼。术前患眼视力手动～0.5，患眼眼压18.3～56.8(平均35.21±10.43)mmHg，眼轴长度19.60～22.46(平均20.63±0.48)mm，中央前房深度0.98～1.86(平均1.31±0.22)mm。所有患者均接受25G+经睫状体扁平部前部玻璃体切除联合后囊膜切开手术治疗。观察治疗前后患者视力、眼压、前房深度、前房炎症反应及并发症等情况。

结果：术后随访6～12(平均9)mo。末次随访：患者最佳矫正视力0.2～0.8，与术前视力比较差异有统计学意义(P<0.01)； 眼压12.3～19.8(平均16.05±2.46)mmHg，与术前眼压比较差异有统计学意义(t=7.59，P<0.01)； 前房深度1.89～3.49(平均2.42±0.47)mm，与术前前房深度比较，差异有统计学意义(t=9.07，P<0.01)； 术后早期1眼术后眼压为8mmHg，经抗炎治疗恢复正常，末次眼压为15mmHg； 所有患者无角膜内皮细胞失代偿、人工晶状体夹持、眼内出血、感染、眼压失控等严重并发症发生。

结论：25G+微创玻璃体手术可安全有效地治疗白内障术后恶性青光眼。

METHODS: Totally 18 eyes of 18 patients with malignant glaucoma after cataract surgery were analyzed retrospectively from January 2013 to June 2016. The visual acuity was between hand moving to 0.5 before surgery, the intraocular pressure was between 18.3-56.8mmHg before surgery, an average of 35.21±10.43mmHg. The length eye axis was between 19.60-22.46mm, an average of 20.63±0.48mm. The depth of anterior chamber was between 0.98-1.86mm, an average of 1.31±0.22mm. All the patients were performed with 25G+ vitrectomy. The visual acuity, anterior chamber and intraocular pressure were studied after treatment.

RESULTS: The patients were followed up for 6-18mo with an average of 9mo. BCVA at the last follow up improved to 0.2-0.8, and there was significant difference compared to that before operation(P<0.01). IOP was from 12.3-19.8mmHg, an average of 16.05±2.46mmHg, there was significant difference compared to that before operation(t=7.59, P<0.01). The depth of anterior chamber was between 1.89-3.49mm, an average of 2.42±0.47mm, there was significant difference compared to that before operation(t=9.07, P<0.01). Only one case had IOP of 8mmHg, after treatment the IOP was 15mmHg. No complications such as corneal endothelium decompensation, intraocular lens(IOL)capture, intraocular hemorrhage, infection and uncontrolled IOP were observed.

CONCLUSION: The 25G+ vitrectomy is safe and effective for treating malignant glaucoma, controls IOP and reduces complications compared with traditional vitrectomy.