青光眼滤过术后恶性青光眼合并睫状体脉络膜脱离

Malignant glaucoma accompanying choroidal detachment after filteration surgery

目的 :探讨青光眼滤过术后恶性青光眼合并睫状体脉络膜脱离的特点及治疗方法。方法 :对 10例 12只眼青光眼小梁切除术后恶性青光眼合并睫状体脉络膜脱离的临床资料作回顾性分析。结果 :4只眼经 1～ 3次脉络膜上腔放液联合抽玻璃体水囊联合前房注气术后 ,3只眼眼压恢复正常 ,1只眼前房不恢复 ,改行前部玻璃体切除联合超声乳化白内障吸除及人工晶状体植入术。其余 8只眼均一次行前部玻璃体切除联合超声乳化白内障吸除及人工晶状体植入术后 ,眼压控制正常 ,前房形成。结论 :青光眼滤过术后恶性青光眼合并睫状体脉络膜脱离为难治并发症。脉络膜上腔放液联合抽玻璃体水囊治疗有效 。

Objective:To investigate the characteristics and the management of the malignant glaucoma and choroidal detachment after filteration surgery.Methods:The clinical histories of 10 patients(12 eyes)with malignant glaucoma accompanying choroidal detachment developed after trabeculectomy were analyzed retrospectively.Results:3 eyes were treated with aspiration of the fluid from the suprachoroidal space 1 to 3 times,combined with injection of sterile air into anterior chamber.8 eyes were treated with anterior vitrectomy,phacoemulsification and posterior chamber intraocular lens (IOL)implantation.All the anterior chambers restored after the surgery with normal intraouclar pressure.Only in one eye,the anterior chamber did not resfored after aspiration of fluid from the suprachoroidal space and vitreous body combine with sterile air injection into anterior chamber,but restored after anterior vitrectomy combined phacoemulsification and posterior chamber IOL implantation,with normal intraocular pressure.Conclusion:Malignant glaucoma with choroidal detachment after filteration surgery is a troublesome complication.It can be treated effectively with aspiration of fluid from the suprachoroidal and vitreous cavities,and success can be obtained also after anterior vitrectomy combined with phacoemulsification and posterior chamber IOL implantation.