摘要
目的:探讨伴无前房、白内障的葡萄膜炎继发性青光眼的手术治疗方法。方法:采用经角膜缘的晶状体和前段玻璃体切除或经睫状体平坦部的晶状体和玻璃体切除联合小梁切除术,对7只眼伴有无前房、白内障的葡萄膜炎继发性青光眼进行了手术治疗,观察术前术后眼压和前房深度变化、滤过泡、视力以及并发症情况,随访时间3~48个月。结果:(1)眼压:7只眼术前平均眼压为(5.18±0.77)kPa,术后1天平均眼压为(0.95±0.29)kPa,术后1周平均眼压为(0.93±0.12)kPa,最后1次随访平均眼压为(1.14±0.70)kPa;(2)前房深度:所有患眼术后均形成前房,中央前房深度为3~5CT;(3)滤过泡情况:所有患眼术后均形成功能滤过泡,滤过泡形态为扁平弥散;(4)视力:1患眼术前视力0.01,术后1周视力CF/20cm,最后1次随访矫正视力0.06;1患眼术前视力0.05,术后1周0.01,最后1次随访矫正视力0.1;余患者多为幼儿,不能配合视力检查但可追光;(5)术后并发症:所有患眼术后早期均有角膜水肿,瞳孔区均有纤维性渗出,房水闪辉(+^++++),但均未出现瞳孔和周切口膜闭、视网膜脱离和眼内炎等并发症。结论:对于葡萄膜炎继发性青光眼同时伴无前房或极浅前房、白内障玻璃体混浊患者,晶状体玻璃体切除联合小梁切除手术能有效降低眼压,形成前房,无严重并发症,是一种治疗伴无前房的葡萄膜炎继发性青光眼安全有效的方法。眼科学报2007;23:238-242.
Purpose ： To evaluate the efficacy of combined trabeculectomy, lensectomy and vitrectomy for the management of secondary glaucoma in uveitis with extremely shallow anterior chamber and cataract.Methods： Combined trabeculectomy, lensectomy and vitrectomy were undertaken for medically uncontrolled intraocular pressure （IOP） on 7 eyes （6 patients, aged from 4 months to 20 years） with secondary glaucoma in uveitis in a retrospective cohort study between 2001 and 2005.Results： The follow-up period ranged from 3 months to 4 years. Deep anterior chamber and functional bleb were observed in all the eyes postoperatively. The average IOP preoperatively, one day postoperatively, one week postoperatively, and the last time of fol- low-up were （5.18 ± 0.77）kPa, （0.95 ± 0. 29 ） kPa, （0.93 ±0.12）kPa, and （1.14 ± 0.70） kPa respectively. No severe complication was observed postoperatively except for the corneal edema and fiber exudation. Conclusions： Combined trabeculectomy, lensectomy and vitrectomy serve as effective and safety treatments for secondary glaucomous uveitis accompanied by extremely shallow anterior chamber, cataract and vitreous opacity. Further intriguing study comparing this combined surgery with combined phacoemulsification and drainage implant surgery is warranted.
出处
《眼科学报》
2007年第4期238-242,共5页
Eye Science
基金
广东省科技计划项目(2002C30901)
