青光眼急性发作缓解后继发睫状体脱离的观察

Observation on the ciliary body detachment after remission of the acute attack of glaucoma

目的观察急性闭角型青光眼急性发作缓解后继发睫状体脱离的相关因素及治疗效果。 方法82例（82眼）急性闭角型青光眼急性发作缓解后收集7眼睫状体脱离，用非接触眼压计及UBM测量缓解前后的眼压及前房深度并进行回顾性分析。 结果急性发作期眼压为（62.71±8.34） mmHg（1 mmHg＝0.133 kPa），中央前房深度为（1.60±0.21） mm。缓解后并发睫状体脱离时的眼压为（9.71±5.06） mmHg，中央前房深度为（1.27±0.20） mm。UBM检查发现继发睫状体脱离7例（7眼），占8.54%。停用毛果芸香碱滴眼并应用糖皮质激素治疗后，7例睫状体脱离均复位。 结论急性闭角型青光眼患者在急性发作缓解后继发睫状体脱离，表现为眼压过低、前房更浅。停用缩瞳剂及应用糖皮质激素是有效的治疗方法。

Objective To observe relevant factors and therapic efficacy of the secondary ciliary body detachment after remission of the acute attack Of primary acute angle-closure glaucoma （PACG）. Methods Clinical data of 82 eyes of 82 patients with PACG were collected. Seven eyes of 7 patients were determined with ciliary detachment by ultrasound biomicroscope （UBM） after remission of the acute attack. The IOP and anterior chamber depth measured with noneontact tromometer and UBM were retrospectively analyzed. Results The IOP was （62.71 _＋ 8.34） mmHg （1 mmHg = 0. 133 kPa） and the central anterior chamber depth was （ 1.60 _＋0.21 ） mm in eyes without ciliary body detachment at the acute attack of PACG. After remission of the acute attack the lOP was （9.71 ＋-5.06 ） mmHg and the central anterior chamber depth was （1.27 -＋ 0.20） mm in eyes with ciliary body detachment. Seven eyes of 7 cases （8.54%） measured by UBM and B ultrasound with ciliary body detachment and without ehoroidal detachment. After the pilocarpine eye dropping was ceased and appropriate amount of glueocorticoid was applied, all the detached ciliary bodies reattaehed. Conclusion After remission of the acute attack of PACG often cause ciliary body detachment. The direct signs of ciliary detachment are ocular hypotension and shallower anterior chamber. Promptly stopping pilocarpine and the appropriate amount of glucoeorticoid is an effective method.