白内障术后睫状环阻滞性青光眼的诊治

Diagnosis and treatment of malignant glaucoma after cataract sugery

白内障术后睫状环阻滞性青光眼指在白内障手术后出现的排除瞳孔阻滞、脉络膜渗漏或脉络膜上腔出血后,存在持续浅前房、高眼压的睫状环阻滞性闭角型青光眼。睫状肌麻痹剂有时可有效缓解病情,药物治疗无效时可试用Nd:YAG激光切开周边虹膜切口处的晶状体囊膜及玻璃体前界膜。玻璃体切除手术宜重点切除虹膜周边切口后的晶状体前后囊膜、部分悬韧带及玻璃体前界膜,从而彻底解除睫状环阻滞,建立从玻璃体腔到前房的房水通道。

Malignant glaucoma or ciliary block angle-closure glaucoma after cataract surgery is characterised by a shallow anterior chamber together with persistently high intraoeular pressure and in the absence of pupillary block or choroidal effusion or suprachoroidal hemorrhage. Cycloplegics may be effective in some cases. Nd：YAG laser may be used to perform posterior capsulotomy combined with hyaloideetomy through a peripheral iridectomy when the medical therapy has failed. The important procedure of vitrectomy includes excision peripheral sector of lens capsule combined with an irideetomy, zonulectomy and hyaloidectomy. The surgery may break ciliary block and build the normal aqueous flow into the anterior chamber.