青光眼滤过术后浅前房形成的原因及治疗

Causes of shallow anterior chamber formation after filtering glaucoma operation and its treatment

目的探讨青光眼术后浅前房形成的原因及处理方法。方法回顾性总结解放军总医院1995年1月-2010年6月期间551例(626眼)青光眼患者行青光眼滤过性手术后发生浅前房的原因及处理方法。结果行青光眼滤过性手术626眼,其中58眼(9.29%)发生浅前房。发生时间在术后1-7d,其中滤过过强46眼(79.3%)、睫状体脉络膜脱离6眼(10.3%)、结膜瓣渗漏4眼(6.9%)、恶性青光眼2眼(3.6%)。需要手术干预才能恢复前房8眼(13.8%),其余50眼通过保守治疗均恢复前房。结论青光眼术后浅前房发生率较高,常见原因是房水滤过过强、睫状体脉络膜脱离及结膜瓣渗漏。通常发生于术后1-2d。大多数浅前房可通过保守治疗治愈,必要时采取手术干预。

Objective To study the causes of shallow anterior chamber formation after filtering glaucoma operation and its treatment.Methods Causes of shallow anterior chamber formation after filtering glaucoma operation and its treatment in 551 glaucoma patients（626 eyes） admitted to our hospital from January 1995 to June 2010 were retrospectively analyzed.Results Shallow anterior chamber was formed in 58（9.29%）out of the 626 eyes 1-7 days after filtering glaucoma operation.Among the 58 eyes after operation,excessive filtration was found in 46 patients（79.3%）,choroid detachment of ciliary body occurred in 6 patients（10.3%）,effusion from conjunctival flap was observed in 4 patients（6.9%）,and malignant glaucoma was detected in 2 patients（3.6%）.Of these 58 eyes,8 needed surgical intervention to recover their shallow anterior chamber,50 had a recovery of shallow anterior chamber after conservative treatment.Conclusion The incidence of shallow anterior chamber is relatively high after filtering surgery due to excessive aqueous over-filtration,choroid detachment of ciliary body,and effusion from conjunctival flap,which usually occurs 1-2 days after operation.The majority of shallow anterior chambers can be cured after conservative treatment and surgical interference should be taken if necessary.