青光眼术后浅前房的临床治疗疗效与原因分析

Clinical treatment effect of shallow anterior chamber after glaucoma surgery and its cause analysis

目的研究并探讨青光眼术后浅前房的发生原因和根据不同的原因进行治疗的临床疗效。方法2010年7月至2013年2月对青光眼进行手术的100例患者的手术方法和术后浅前房的发生率、类型、处理方法和时间等资料进行回顾性分析。结果在本组研究的160眼中，有1度浅前房29眼，2度浅前房22眼，3度浅前房6眼，共浅前房57眼。术后1～3d即出现浅前房的有51眼，占89．5％；术后4d即出现浅前房的有6眼，占10．5％。57浅前房眼中，40眼房水滤过过强型，9例结膜瓣渗漏，8例睫状体和脉络膜脱离的患眼。57眼经保守治疗，在1周内恢复的前房眼有40眼，在7～12d恢复的前房眼有12眼，有2例3度浅前房眼患者在15d仍无好转迹象，3眼发生结膜瓣渗漏。结论浅前房是青光眼患者在滤过术后较为多发的，造成这种现象的主要原因是房水的滤过性过强，其次是结膜瓣发生渗漏，大多数患者通过非手术进行治疗，尤其是3度浅前房最应进行及早的手术治疗。

Objective To study the causes of shallow anterior chamber after glaucoma surgery and to explore the clinical efficacy of its treatment according to different causes. Methods July, 2010 to February, 2013, the surgical methods and the incidence, causes, types, treatment approaches and time, etc. of postoperative shallow anterior chamber in 100 patients undergoing glaucoma surgery were retrospectively analyzed. Results Among the 160 eyes, 57 eyes got shallow anterior chamber; of which, 29 eyes were degree Ⅰ , 22 Ⅱ , and 6 Ⅲ . 51 eyes （89.5%） got shallow anterior chamber within 1-3 days after the operation, and 6 （10.5 %） 4 days. Among the 57 eyes, 40 were the type of strong filtration of chamber aqueous humor, 9 had conjunctival flap leakage, and 8 got ciliary body and choroidal detachment. After the conservative treatment for the 57 eyes, 40 recovered within one week and 12 within 7-12 days, 2 of degree Ⅲ got no improvement after 15 days treatment, and 3 occurred conjunetival flap leakage. Conclusions Shallow anterior chamber happen a lot in the patients undergoing glaucoma filtration surgery. Its top cause is strong fihration of chamber aqueous humor. And conjunctival flap leakage comes next. Most patients can be treated non-surgically. However, patients of degree Ⅲ should be surgically treated as soon as possible.