恶性青光眼四联手术及术后并发症的预防和处理

Four-union-surgery for malignant glaucoma and prevention of postoperative complications

目的探讨恶性青光眼四联手术及对术后并发症的预防和处理。方法对恶性青光眼22例26眼行白内障摘出、玻璃体切割术及人工晶状体植入术。结果术前Ⅱ级、Ⅲ级浅前房均一次性前房形成。矫正视力均不同程度较术前提高,眼压由术前(34.64±7.06)mmHg(1kPa=7.5mmHg)降至术后(15.15±2.15)mmHg。术后2例3眼1周再次浅前房、高眼压,经处理后恢复正常。1例1眼术后玻璃体积血,经后段玻璃体切割术后,视力提高。结论多种联合手术是恶性青光眼安全、有效的治疗方法。二次浅前房时只需加强治疗及YAG激光可恢复正常。

Objective To discuss the effect of four-union-surgery for malignant glaucoma, and to prevent and cure of postoperative complications. Methods Twenty-six eyes of 22 patients underwent combined cataract extraction, vitrectomy and intraocular lens implantation. Results Both shallow anterior chamber of grade Ⅱ and grade Ⅲ before operation recovered to normal depth at once. Corrected visual acuity elevated to a certain degree and intraocttlar pressure dropped from （ 34.64 ± 7.06 ） mmHg （ 1 kPa = 7.5 mmHg） before operation to （ 15.15 ± 2.15 ） mmHg after operation. Three eyes of 2 patients after operation occurred shallow anterior chamber again, but recovered to normal depth after treatment. One eye of 1 patient occurred vitreous hemorrhage after operation and the visual acuity elevated after vitrectomy. Conclusion Four-surgery is a safe and effective treatment for malignant glaucoma. Intensive therapy and YAG laser can cure twice shallow of anterior chamber. [ Rec Adv Ophthalmol 2008;28（2） ：145-146]