青光眼小梁切除术后浅前房的原因分析及处理

To study the common causes and the managements of shallow anterior chamber after trabeculectomy of glaucoma

目的分析青光眼小梁切除术后浅前房形成的常见原因及处理方法。方法同顾性总结142例167只眼行小梁切除术后浅前房的原因、处理及转归。结果167只眼行小梁切除术后发生浅前房48只眼，浅前房发生率为28．74％；其中滤过过畅29只眼，脉络膜脱离15只眼，结膜、巩膜瓣漏共3只眼，恶性青光眼1只眼。根据浅前房原因及程度不同行保守治疗或手术治疗后恢复。结论青光眼小梁切除术后浅前房发生率较高，其中常见原因是房水滤过过畅、脉络膜脱离。持续、严重浅前房可引起并发症影响视功能。Ⅰ度浅前房经保守治疗可恢复，Ⅱ度浅前房持续4～5天应手术治疗，Ⅲ度浅前房须及早手术。

Objective To study the common causes and the managements of shallow anterior chamber after trabeculectomy of glaucoma. Methods 142 consecutive patients（167 eyes） with glaucoma were undergone trabeculectomy on the cause, management and result of postoperative shallow anterior chamber. Results The incidence of postoperative shallow anterior chamber in all the eubjects and in the patients undergone operation of rabeculectomy was 28.74% （48/167 eyes. ） The causes of shallow anterior chamber were excessive aqueous over filtration（29 eyes） ,choroidal detachment（15 eyes）, filter bleb leaks（3 eyes）, malignant glaucoma （1 eye）. The managements of shallow anterior chambers were surgical procedure or conservative procedure by the cause and degree. Conclusion The incidence of postoperative shallow anterior chamber is high after trabeculectomy,the common causes of shallow anterior chamber were excessive aqueous over filtration,choroidal detachment. The continuous and deep shallow anterior chamber could cause complications and affect visual function. Ⅰ degree shallow anterior chamber needed conservative procedure, Ⅱ degree shallow anterior chamber that was being in from 4 to 5 days needed surgical procedure, Ⅲ degree shallow anterior chamber needed surgical procedure in time.