真性小眼球术后恶性青光眼的治疗

The management of ciliary block glaucoma in nanophthalmic patients

目的探讨真性小眼球合并恶性青光眼的手术治疗的时机、方法及疗效。方法7例真性小眼球合并恶性青光眼的患者施行青光眼小梁切除术联合白内障超声乳化＋人工晶状体植入、用23G经结膜无缝合玻璃体前段切除术，平均随访2年。结果所有患者术后视力稳定或提高，眼压控制在10-20mmHg，未发生严重并发症。结论真性小眼球合并恶性青光眼的患者施行青光眼小梁切除术联合门内障超声乳化＋人工晶状体植入、用23G经结膜无缝合玻璃体前段切除术是安全和有效的。

Objective To discuss the method and effect of the treatment to nanophthalmos wire developed ciliary block glaucoma after glaucoma or cataract surgery. Methods Seven cases who had been diagnosed nanophthalmos with developed ciliary block glaucoma after glaucoma or cataract surgery were treated bgcombining trabeculectomy, phacoemulsification, foldable intraocular lens im- plantation, transconjunctival sutureless vitrectomy in anterior segment using 23-gauge instruments （tri- ple procedure）. The average follow-up time was 2 years. Results Corrected vision of 7 cases were enhanced after the operation and the intraocular pressure were kept stability between 10-20mmHg. Seriously threatening the visual function during and after an intraocular operation was not occurred. Conclusions It is an effective and safe surgery combined trabeculectomy, phacoemulsification, fold-able intraocular lens implantation, transconjunctival sutureless vitrectomy in anterior segment using 23- gauge instruments, in curing nanophtalmos with developed ciliary block glaucoma. The vitrectomy in anterior segment using 23-gauge instruments in curing nanophtalmos developed ciliary block glaucoma may reduce the disastrous complications of filtration surgery.