发育性青光眼首选治疗的临床探讨

Clinic investigation concerning treatment of development glaucoma

对发育性青光眼按治疗经过分为首选手术组（５４例１００眼）和首选药物组（４８例９５眼）二组，术后追踪３年。结果：首选手术组手术成功率７７％，平均眼压２．６７±１．９９ｋＰａ，视力、视野及Ｃ／Ｄ稳定率分别为７１％、６９％、７１％。首选药物组，坚持治疗达３年以上者仅７例１３只眼，这１３只眼的眼压控制率为５３％，视力、视野及Ｃ／Ｄ稳定率分别为４６％、５３％，４６％。药物治疗的其余４１例８２只眼，分别在用药物后半年至一年半时间内，因眼压不能控制，药物顺从性差或药物的副作用等，转行手术治疗。转行手术后眼压控制率与首选手术组无统计学上的差异（Ｐ＞０．０５）。结果表明发育性青光眼首选手术与首选药物治疗相比，在眼压控制，视力、视野及Ｃ／Ｄ稳定方面均优于首选药物治疗组。因药物治疗顺从性差和欠佳。

To investigate the optimum treatment of development glaucoma.102 cases(195eyes)of development glaucoma were divided into two groups.Initial surgical treatment group (54cases,100eyes)and initial medical treatment group(48cases,95eyes).All patients were followed up 3 years and more.The control rate of IOP in surgery groups,was 77%,mean IOP was 2 76±1 99kPa.The stable rate of visual acuity,visual field and C/D were 71%,69% and 71%,respectively.In initial medical treatment group,there were only 7 cases(13eyes)maintaining medical therapy during 3 years followup.The control rate of IOP was 53%,mean IOP was 3 68±2 03 kPa.the stable rate of visual acuity,visual field and C/D were 46%,53% and 46%,respectively.The other 41 cases of 82 eyes were converted to surgery because of lose control of IOP,development of visual field defect,poor drug compliance and drug side effect.The successful rate of postoperation was as about the same as initial surgical treatment.(P>0 05).This article presents evidence suggesting that initial surgery in the development glaucoma provides better IOP control,good visual field preservation and visual acuity than medical treatment does.Poor compliance and results with initial medical treatment will converted 86% patients to surgery,so we prefer initial surgery for development glaucoma.