急性闭角型青光眼持续高眼压的手术治疗

Surgery of acute angle-closure glaucoma with continuous high intraocular pressure

目的:探讨持续高眼压状态下急性闭角型青光眼手术治疗的方法和疗效。方法:对使用多种药物3天不能控制眼压(≥40 mmHg)的56例(56眼)患者施行小梁切除术。术前尽量降低眼压,术中少量、缓慢、多次释放房水,使用可调整缝线,术后恢复前房防止眼压过低。结果:未出现脉络膜上腔爆发性出血和恶性青光眼。术后患眼视力0.01～0.1 16眼,>0.1～0.8 40眼,均好于术前高眼压状态下视力(P<0.01)。术后眼压≤21 mmHg 48眼。较术前明显降低(P<0.01)。术后3例脉络膜脱离,2例滤过过强致前房迟缓形成,2例滤过不畅致高眼压,均经过治疗后恢复。结论:持续高眼压急诊行小梁切除术是可行而且必要的。

Objective：To explore the method and clinical effect of trabeculectomy for acute angle-closure glaucoma（ACG） with continuous high intraocular pressure（IOP）.Methods：Fifty-six patients（56 eyes） were accepted trabeculectomy whose IOP were continuously over 40 mmHg after use of repressive pressure medicine more than 3 days,including dropping IOP before surgery,releasing aqueous humor slowly and repetitiously,using releasable suture and injecting blind source separation to renew the anterior chamber depth.Results：There were no serious complications such as suprachoroidal space bleeding and malignant glaucoma.The vision was between 0.01-0.1 in 16 eyes,0.1-0.8 in 40 eyes.Most of the cases had better vision than before（P〈0.01）.The post-operative IOP was ≤21 mmHg in 48 eyes,which was significantly lower than before surgery（P〈0.01）.Choroidal detachment was occurred in 3 eyes,delayed anterior chamber reformation for strong filteration in 2 eyes,and high IOP for low filteration in 2 eyes.Conclusions：It is necessary and safety to do trabeculectomy for ACG with continuous high state of IOP.