超声生物显微镜评价小梁切除术治疗急性闭角型青光眼

Evaluation of trabeculectomy for the treatment of acute angle-closure glaucoma by ultrasound biomicroscopy

目的:应用超声生物显微镜观察急性闭角型青光眼小梁切除术的有效性和安全性。方法:选取80例80眼急性闭角型青光眼病例按手术前眼压水平分为高眼压组(30例30眼,眼压≥30mmHg)和对照组(50例50眼,眼压<30mmHg),对两组病例小梁切除术后眼压、视力以及超声生物显微镜(ultrasound biomicroscopy,UBM)情况等进行统计比较。结果:高眼压组术后大多数保留了较好的视力;两组病例术后眼压大多控制在8～15mmHg;UBM检测结果,高眼压组术后发生1例睫状体脱离,1例恶性青光眼,1例浅前房,对照组术后发生1例浅前房,两组比较差异无显著性(P>0.05);两组患者手术后ACD,AOD,TCPD术前术后比较差异均无显著性。结论:急性闭角型青光眼高眼压下小梁切除术是有效、安全的,在充分药物治疗后,应及时采取手术治疗。UBM检查可发现小梁切除术后睫状体脱离、恶性青光眼等严重并发症,在急性闭角型青光眼诊治过程中发挥重要作用。

AIM： To observe the efficacy and safety of trabeculectomy in the primary acute angle-closure glaucoma by ultrasound biomicroscopy.METHODS： Eighty cases 80 eyes of primary acute angleclosure glaucoma, which received trabeculectomy, were divided into 2 groups by the preoperational intraocular pressure（lOP） value, the high lOP group： 30 cases 30 eyes, IOP≥30mmHg, the control group： 50 cases 50 eyes, IOP 〈 30mmHg. And after surgery, routine examinations such as IOP, visual acuity and ultrasound biomicroscopy （UBM） were observed and analyzed. RESULTS： Most patients of high lOP group gained a better vision. The IOP of both groups were controlled between 8 to 15mmHg after surgery. In high IOP group, cyclodialysis was observed in 1 case, malignant glaucoma was observed in 1 case and shallow anterior chamber was observed in 1 case. Shallow anterior chamber was observed in 1 case of the control group. Anterior chamber depth （ ACD ）, angle opening distance （ AOD ） and trabecular-ciliary process distance （TCPD） after operation compared with the preoperative had no significant differences. CONCLUSION： Trabeculectomy for AACG with persistent high IOP is safe and effective. Trabeculectomy should be performed promptly after using adequate remedies. UBM can find cyclodialysis, malignant glaucoma and shallow anterior chamber after trabeculectomy. UBM plays an important role in the treatment of acute angle-closure glaucoma.