术中前房穿刺在持续高眼压状态下原发闭角型青光眼手术中的应用

Paracentesis of anterior chamber in primary angle-closure glaucoma with persistent high intraocular pressure

目的:观察在原发性青光眼持续高眼压状态下小梁切除术中运用前房穿刺的效果。方法:59例眼压控制不良的原发性青光眼患者随机分为实验组和对照组:对照组为术前1-2d裂隙灯下前房穿刺降眼压后再行小梁切除术,治疗组为小梁切除术中行前房穿刺缓降眼压,并对两组进行临床疗效观察。结果:对照组术后1月视力改善无显著性差异,术后1d、3d、1周、两周内眼压控制有明显差异;实验组眼压相对平稳,术后3月时两组眼压变化无显著差异,术后3月两组滤过泡比较无明显差异。结论:术中前房穿刺术对于持续高眼压状态下青光眼行之有效,是一种安全有效的治疗方法。

Objective： To observe the clinical effect of paracentesis of an- terior chamber before trabeculectomy in treatment of primary angle-closure glaucoma with persistent high intraocular pressure. Methods： Fifty-nine cases with primary glaucoma in failure to reducing the intraocular pressure were randomized into two treatment or control group for observing the resuits. Patients in the control group underwent paracentesis of anterior chamber with aid of slit lamp 1 - 2 days prior to the trabeculectomy for reducing the intraocular pressure, whereas those in the treatment group received intraoperative paracentesis of anterior chamber. Results： There was no significant difference in visual acuity in the two groups 1 month after the surgery, but the intraocular pressure differed greatly on day 1 and 3, in week 1 and 3 after the procedure. The intraocular pressure in the controls remained stable and that, together with filtering blebs, showed no change in both groups 3 months after the operation. Conclusion： Intraoperative paracentesis of anterior chamber is safe and effective in glaucoma with persistent high intraocular pressure.