持续高眼压状态下手术治疗急性闭角型青光眼33例

33 cases on surgical therapy for acute angle-closure glaucoma with persistent ocular hypertension

目的探讨对降眼压治疗效果不佳的闭角型青光眼在高眼压状态下行手术治疗的疗效。方法回顾性分析笔者所在医院2007年5月～2010年10月治疗的33例33眼应用药物不能控制眼压的急性闭角型青光眼患者,所有患者均行复合式小梁切除术治疗。术后随访6～12个月。结果所有患者手术均顺利完成,术中术后均未出现严重并发症,术后视力获得明显的提高;术后1周所有患者眼压均在8～11mmHg,经6～12个月随访,患者眼压基本控制在14.36～21.58mmHg。结论原发性闭角型青光眼持续高眼压状态下的复合式小梁切除术是安全有效的。手术治疗的术前、术中、术后都应积极处理高眼压,提高手术的成功率,预防和减少术中及术后并发症的发生。

Objective To discuss the effects for treating acute angle-closure glaucoma with persistent ocular hypertension. Methods 33eyes（33cases） of uncontrolled acute angle-closure glaucoma were treated by combining trabeculectomy from 2007 May to 2010 October,follow-up of 6 ～ 12 months after surgery. Results The operation of 33 eyes were successful and without serious complications. The visions of 33 cases were acquire significant increase. The IOP was between 8 mmHg and 11 mmHg in the first week,after 6 to 12 weeks follow-up,the IPO were controlled from 14.36 to 21.58 mmHg. Conclusion Combining trabeculectomy and paracentesis of anterior chamber for treating acute angle-closure glaucoma with persistent ocular hypertension was safe and effective. The persistent ocular hypertension should be handled from any time of operation,it will enhance the effect of surgery,prevent and decrease the complications that caused by operation.