前房穿刺术结合小梁切除术治疗急性闭角型青光眼高眼压持续状态的临床分析

Clinical study on anterior chamber paracentesis combining with trabeculectomy in treatment of persistent status of high intraocular pressure caused by acute angle-closure glaucoma

目的探讨前房穿刺术结合小梁切除术治疗急性闭角型青光眼(AACG)高眼压持续状态的疗效。方法以2010年1～12月收治的AACG高眼压持续状态患者41例41眼为治疗组,以2009年1～12月收治的AACG高眼压持续状态患者40例40眼为对照组。治疗组给予前房穿刺术,待眼压控制3～4 d后再行小梁切除术;对照组给予前房穿刺术,待眼压降低后立即行小梁切除术,比较两组临床疗效。结果两组术后眼压均得到有效控制,但治疗组术后视力明显高于对照组;治疗组术后瞳孔无粘连率明显高于对照组,差异均具有统计学意义(P<0.05)。结论前房穿刺放液,使患眼房水快速引流,待眼压控制3～4天后,局部充血水肿好转,再行小梁切除术,疗效更为显著。

Objective To study the effect of anterior chamber paracentesis combining with trabeculectomy in treatment of persistent status of high intraocular pressure caused by acute angle-closure glaucoma（AACG）.Methods Forty-one eyes of 41 patients with persistent status of high intraocular pressure caused by AACG in this hospital during January to December,2010 were allocated into trial group.Forty eyes of 40 patients with persistent status of high intraocular pressure due to AACG in this hospital during January to December in 2009 were allocated into control group.Patients in trial group received anterior chamber paracentesis,and persistent status of intraocular pressure was controlled for 3-4 days,then they received trabeculectomy.Patients in control group received trabeculectomy at the time when intraocular pressure was decreased by anterior chamber paracentesis.The effect of treatment was compared between these 2 groups.Results The postoperative intraocular pressure in patients of these 2 groups were effectively decreased.However,postoperative visual acuity in patients of trial group was higher than that of patients in control group.The adhesionless rate in pupil of patients in trial group was lower than that of patients in control group.Their difference was statistically significant（P0.05）.Conclusion Anterior chamber paracentesis rapidly drained off the aqua of AACG.After the control of intraocular pressure for 3-4 days,local congestion and edema had been improved.Trabeculectomy performed at this time,its effect for relieving high intraocular pressure caused by AACG will be more significant.