晶状体悬韧带松弛及部分断裂继发青光眼的临床特点及治疗方法探讨

A clinical investigation to glaucoma secondary to chalasia and/or dialysis of the lens zonular fiber

目的 探讨晶状体悬韧带松弛及部分断裂继发青光眼的临床特点及治疗方法。方法 回顾性分析晶状体悬韧带松弛及部分断裂继发青光眼实施晶状体摘除手术的患者23例23眼。18眼术前表现为急性闭角型青光眼的临床特点，5眼术前发现瞳孔区玻璃体疝伴高眼压。治疗采用晶状体超声乳化术，部分患者联合前部玻璃体切除术，根据晶状体悬韧带松弛及断裂程度实施人工晶体囊袋内植入术或人工晶体悬吊术。结果 术后所有患者眼压均控制在正常范围，视力恢复到0．3～1．0不等。结论 晶状体悬韧带松弛及部分断裂继发青光眼患者的临床表现与原发性急性闭角型青光眼极其相似，必须加以鉴别。根据悬韧带松弛、断裂的程度和玻璃体状态选择不同的手术方式，可以获得良好疗效。

Objective To investigate the etiology, manifestations and treatment of glaucoma secondary to chalasia and/or dialysis of the lens zonular fiber. Methods We studied 23 cases which suffered glaucoma secondary to chalasia and/or dialysis of the lens zonular fiber and received lens extraction retrospectively. Before operations, 18 eyes displayed as acute angle-closure glaucoma, 5 eyes showed visible vitreous hernia in pupil area with high intraocular pressure. Phaco emulsification cataract extraction or phaco emulsification cataract extraction combined with anterior vitrectomy as well as posterior chamber lenses implanted into the capsular bag or transsclerally sutured were performed in all cases according to the different instances of zonular fiber. Results After operation, all the cases obtained good intraocular pressure control and the visual acuity increased from 0.3 to 1.0. Conclusions It is very important to differentiate the patients of glaucoma due to chalasia and/or dialysis of the lens zonular fiber from acute angle-closure glaucoma for they had similar signs. Good surgical outcomes can be abtained via different types of operations according to different situations of zonular fiber.