复合式小梁切除术治疗急性闭角型青光眼持续高眼压的临床观察

Clinical observation of compound trabeculectomy on acute angle-closure glaucoma with persistent high intraocular pressure

目的探讨急性原发性闭角型青光眼(APACG)持续高眼压状态下进行复合式小梁切除术治疗的手术特点、手术可行性、安全性及效果。方法回顾性分析对32例(36只眼)经大剂量降眼压药物等综合治疗2～3d眼压仍≥40mmHg的患眼行复合式小梁切除术。结果术中及术后均未出现暴发性脉络膜上腔出血、眼内出血、恶性青光眼等严重并发症,术后视力明显提高,1只眼低眼压,2只眼浅前房,2只眼前房积血,经治疗观察后1个月内逐渐恢复。结论 APACG持续高眼压经药物及前房穿刺治疗不能有效控制的病例,复合式小梁切除术是安全有效的治疗方法,可避免视功能的进一步损害。

Objective To explore the characteristics,feasibility and effect of compound trabeculectomy on acute primary angle-closure glaucoma （APACG） with persistent high intraocular pressure. Methods Compound trabeculectomy was performed on 32 cases （36 eyes） PACG with persistent high intraocular pressure （≥40 mm Hg） after high-dose medical treatment for 2~3 days. The complications and postoperative efficacy was retrospectively analyzed. Results The intra-or postoperation complications such as suprachoroidal expulsive hemorrhage,intraocular bleeding and malignant glaucoma did not occure. In the 36 eyes of operation,all visual acuity were obviously improved. Low intraocular pressure （1 eye）,shallow anterior（2 eyes） and hyphema （2 eyes） were found and healed gradually during the first one month fellow up after treatment. Conclusion To APACG with persistent high intraocular pressure,compound trabeculectomy is an effective and safe treatment,which may avoid further damage on visual function by high intraocular pressure.