青光眼滤过术的浅前房临床探讨

Shallow Anterior Chamber after Filtering Operation in Patients with Glaucoma

目的:探讨青光眼滤过性手术后浅前房发生的原因、治疗及其预防。方法:回顾本院2001年1月-2007年10月收治青光眼患者182例共229只眼滤过性手术后发生浅前房情况,统计分析其发生原因、治疗结果。结果:182例229只眼中浅前房者62例66只眼,发生率为28.82%(66/229)。最常见原因是滤过过强(69.70%,46/66),其它依次为结膜瓣渗漏(12.12%,8/66),外力作用于术眼(10.60%,7/66),脉络膜脱离(7.58%,5/66)。浅前房66只眼中,61只眼(92.42%,61/66)经保守治疗形成前房,其它5只眼需手术治疗。结论:青光眼滤过术后浅前房发生率较高,滤过过强为主要发生原因,应重视其术前、中、后的每一环节,减少其发生率。浅前房多数可通过保守治疗而恢复。

Objective： To study the common causes, prevention and management of shallow anterior chamber after filtering operation of glaucoma. Methods： 182 patients （229 eyes） with glaucoma who underwent filtering operation from January 2001 to October 2007 in the department of Ophthalmology, Haikou Municipal Hospital were retrospectively studied on the causes, prevention and management of postoperative shallow anterior chamber. Results： The incidence of postoperative shallow anterior chamber in all the subjects was 28.82% （66/229）. Excessive aqueous over filtration （69.7%, 46/66）, bleb leak （12.12%, 8/66）, impacts of external forces （10.60%, 7/66）and choriodal detachment （7.58%, 5/66） were found to be the most common causes. Anterior chamber reformed in 61 eyes （92.42%, 61/66） with conservative treatment, while the other 5 eyes required surgical procedure for reformation of the anterior chamber. Conclusion ： The incidence of shallow anterior chamber is high after filtering operation, frequently caused by excessive aqueous oveffiltration. While most of shallow anterior chamber can he addressed with conservative management, attention should be drawn to oversee every aspect before, during and after an operation, so as to reduce the incidence of such condition.