76例急性闭角型青光眼持续高眼压下行抗青光眼手术的临床效果评价

Anti-glaucoma surgeries under high intraocular pressure in 76 acute angle-closure glaucoma patients

目的探讨在持续高眼压下行抗青光眼手术的临床疗效。方法对76例(76只眼)经常规降眼压处理后眼压仍大于40 mm Hg的急性闭角型青光眼患者行抗青光眼手术,观察术后视力、眼压及滤过泡等情况。结果行小梁切除术38只眼,行超声乳化白内障摘除联合房角分离术26只眼,行超声乳化白内障摘除联合小梁切除术12只眼,术后66例视力较术前有明显提高,术后眼压符合完全成功67只眼(78.1%),符合条件成功4只眼(12.5%),平均眼压(15.88±6.32)mm Hg,5只眼(9.4%)失败,27只眼滤过泡为功能性滤过泡,5只眼为非功能性滤过泡。结论对持续高眼压性青光眼行抗青光眼手术,需依据病情采取不同治疗举措,可取得降低眼压,提高视力,保护视功能的效果。

Objective To investigate the clinical efficacy of glaucoma surgery under sustained high intraocular pressure. Methods Seventy-six cases（ 76 eyes） of acute angle-closure glaucoma patients whose intraocular pressure was greater than 40 mm Hg after drug treatment were treated with emergent glaucoma surgery. Postoperative visual acuity,intraocular pressure（ IOP） and the filtering bleb formation were evaluated. Results Thirty-eight eyes were operated with trabeculectomy,26 eyes with phacoemulsification cataract extraction combined anterior chamber angle separation,and 12 eyes with phacoemulsification cataract extraction combined trabeculectomy. All patients＇ postoperative visual acuity significantly improved after surgeries. With regard to IOP,surgeries were successful in 67 patients（ 78. 1%）,qualitatively successful in 4 cases（ 12. 5%）,and failed in 5 cases（ 9. 4%）. Average IOP was 15. 88 ± 6. 32 mm Hg. In 27 cases,filtering bleb functioned properly. In 5 cases filtering bleb was non-functioning. Conclusion verall,surgical treatments resulted satisfactory clinical outcomes in patients with continuously high IOP.