真性小眼球术后出现恶性青光眼的治疗

The Treatment Methods for Nanophthalmos Patients Who Were Diagnosised Malignant Glaucoma after Operation

目的探讨真性小眼球继发青光眼患者术后出现恶性青光眼的治疗。方法 15例(18眼)诊断为真性小眼球继发青光眼术后出现恶性青光眼的患者,随机分为两组,A组7例(10眼)行白内障超声乳化吸除联合前部玻切术,一月后行人工晶体植入术;B组8例(8眼)行白内障超声乳化吸除、前部玻切联合人工晶体植入术。结果术后A组视力提高者9眼,视力无变化一眼,眼压稳定在10~20 mm Hg;B组视力提高者6眼,视力无变化一眼,视力下降一眼,6眼眼压在10~18 mm Hg,2眼高眼压,1眼脉络膜渗漏,两周后恢复。结论对于处理真性小眼球继发青光眼术后出现恶性青光眼的患者摘除晶状体后不宜过早植入人工晶体。

Objective To discuss the comparison of treatment methods for nanophthalmos secondary glaucoma patients who were diagnosised malignant glaucoma after operation. Methods 15 patients（ 18 eyes） who were diagnosised malignant glaucoma after operation for nanophthalmos secondary glaucoma were randomly divided into two groups. 7 cases（ 10 eyes） of group A received phacoemulsification and anterior vitrectomy in the first stage. And then an intraocular lens implantation was performed on these patients in a month. 8 cases（ 8 eyes） of group B received phacoemulsification,anterior vitrectomy and intraocular lens implantation together. Results 9 eyes＇ corrected vision improved and 1 eye remained unchanged in group A after operation. And their intra-ocular tension stabilised at 10 to 20 mm Hg. On the other side,6 eyes＇ corrected vision improved,1 eye remained unchanged and 1 eye decreased in group B. At the same time,the intra-ocular tension of 6 eyes is stabilised at 10 to 18 mm Hg. 2 eyes were hypertension,and were complicated by malignant glaucoma. Choroidal effusion occurred in 1 eye and recovered after two weeks. Conclusions Intraocular lens should not be prematurely implanted after removal of the lens for the nanophthalmos secondary glaucoma patients who were diagnosised malignant glaucoma after operation.