急性闭角型青光眼前房角分离术的初步应用

Preliminary utilization of goniosynechialysis for acute angleclosure glaucoma

目的探讨一种新的急性闭角型青光眼手术的技术效果。方法运用前房角分离技术或联合白内障摘出治疗28例(28眼)药物不能控制眼压的急性闭角型青光眼,并测量术后1周、10月的眼压。结果术后1周眼压均低于21mm-Hg;10月复查,患病1年之内的21例中眼压控制18例(85.71%),患病1年之上的7例中眼压控制5例(71.43%)。结论前房角分离术是将前粘连的周边虹膜从前房角上分离开,恢复小梁的功能,充分运用其生理性的房水循环通道,该术式损伤小,术后恢复快,再发生粘连可以重复手术,小梁功能丧失后可以重新做眼外引流手术。

Objective To evaluate the efficacy of goniosynechialysis. Methods In 28 cases（28 eyes） of uncontrolled acute angle-closure glaucoma, 17 cases （ 17 eyes） were treated with thenew method of the goniosynechialysis, and the combined goniosynechialysis and cataract extraction for 11 cases（ 11 eyes）. The intraocular pressures at 1 week and 10 months follow up were measured. Results All the intraocular pressures of patients at 1 week follow up were under 21 mmHg,At the 10 months follow up,the intraocular pressure control rate was 85.71% in the group that medical history were under 1 year, and was 71.43% in that medical history were beyond 1 year. The curative effect was very obvious. Conclusions The goniosynechialysis is an operation separating the periphery iris from the anterior chamber angle, and recover the function of trabecular neshwork and physiological aqueous outflow channels. It has the merits of simplicity and fewer complications. If un- successful, re-operating or routine trabeculectomy can be carried on.