睫状环阻塞性青光眼治疗的临床分析

Clinic analysis in treatment of ciliary block glaucoma

目的探讨睫状环阻塞性青光眼的联合治疗方法并评介其疗效。方法回顾性分析2002年11月至2008年10月经治的11例(11眼)睫状环阻塞性青光眼的临床资料,4例药物治疗;其余7例采用不同的手术治疗:对于青光眼手术后发生的睫状环阻塞性青光眼4例行前段玻璃体切除、前房形成、房角分离联合晶状体超声乳化人工晶状体植入术;对于白内障摘出联合抗青光眼术后发生的3例,其中1例行部分晶状体后囊切开、玻璃体前界膜及前部玻璃体切除:另2例行人工晶状体摘出,后囊连续环行撕囊联合前段玻璃体切除术,其中1例摘出人工晶状体稳定半年后行人工晶状体二期植入。结果 11例前房均恢复并保持良好,视力提高,平均眼压(15.3±2.7)mmHg,未发生严重的并发症。结论睫状环阻塞性青光眼是一种有多种因素造成的难治性青光眼,早期药物治疗有效,如药物治疗无效,需行手术治疗。

Objective To explore the united therapeutical methods available for ciliary block glaucoma and to evaluate the effects. Methods The c3inical data collected from November 2002 to October 2008 were analyzed retrospectively. Different therapeutical schemes and operational occasion were retrospectively analyzed in 11 eases （11 eyes ） of ciliary block （malignant） glaucoma. 4 were medicated; for the rest were undergone different operation. The 4 case of ciliary-blocking glaucoma after regular glaucoma surgery had undergone anterior vitreetomy, anterior chamber reformation, separation of angle of anterior chamber, phacoemulsifieation and IOL implantation. 3 ease of ciliary-blocking glaucoma occurred ＇after combined surgery of cataract and glaucoma. Posterior capsular incision and anterior vitrectomy were performed in one ease. IOL extraction,CCC and anterior vitrectomy were performed in the other two cases. In which IOL implantation was done 7 months after the IOL extraction. Results Anterior chambers were reconstructed and kept well in all of the 11 eases. The mean intraocular pressure was （ 15.3 ± 2.7 ） mmHg postoperatively. No serious complication was observed. Conclusion Ciliary block glaucoma is refractory glaucoma with many pathogenetic factors, on which medication is effective in early period, while muhiply surgery should be used in advanced stage.