百力特滴眼液于急性闭角型青光眼治疗中的应用

Clinical Observation of Pred Forte Eyedrops in Treatment of Acute Angle-closure Glaucoma

目的探讨急性闭角型青光眼患者百力特滴眼液治疗中的应用效果。方法分析2014-01/2016-01我院眼科收治的高眼压持续状态的急性闭角型青光眼患者57例61眼,一期行前房穿刺术,术后局部使用百力特滴眼液,配合使用派立明、阿法根滴眼液和甘露醇注射液静滴等进一步控制眼压。术后第2 d行小梁切除羊膜植入联合前房注气术后随访观察矫正视力、眼压,裂隙灯、眼底检查并记录并发症发生情况。结果青光眼滤过手术后第1、3、7 d,1 mo随访时眼压分别为19.3±3.7、15.4±3.9、14.3±3.9、15.7±4.7 mmHg,与术前眼压分别比较,差异均有统计学意义(F=743.109,P<0.01);至末次随访期间观察术眼100%均已形成功能性滤过泡,手术完全成功率为94%,部分成功率为3%,大部分患者术眼恢复了有用的视力。未发现恶性青光眼、脉络膜上腔出血、眼球萎缩等严重并发症发生。结论百力特滴眼液在术前术后应用中可以有效控制患眼炎症反应,为二期手术提供良好的条件。

Objective To observe clinical curative effect of Pred Forte Eyedrops in primary angle closure glaucoma.Methods From January 2014 to January 2016, 57 patients(61 eyes) with high intraocular pressure in primary angle closure glaucoma were treated in the Department of ophthalmology in our hospital. Under local anesthesia underwent paracentesis of anterior chamber, postoperative topical Pred Forte Eyedrops and intraocular pressure lowering drops of eye drops and glycerol and fructose injection intravenous and further control the intraocular pressure(IOP). After second days of trabeculectomy with amniotic membrane implantation and intracameral gas injection. Best corrected visual acuity, intraocular pressure, slit lamp, fundus examination and recording of complications occurred during the operation.Results The average IOP after glaucoma filtration surgery was(19.3±3.7) mmHg at 1 day、(15.4±3.9) mmHg at 3 day、(14.3±3.9) mmHg at 7 day and(15.7±4.7) mmHg at 1 month,which was significantly lower than those before surgery(F=743.109,P<0.01). At the last visit,the functional filtering bleb formed in all cases.The fully success rate was 94%,the partially success rate was 3%. And most of cases regain useful visual acuity.There were shallow anterior chamber in 3 eyes and chorildal detachment in 2 eyes,which were treated medically.Malignant glaucoma,retinal hemorrhage,suprachoriodal hemorrhage and other severe complications did not occur.Conclusions Pred forte eyedrops can effectively control eye inflammation in the application before and after surgery, provide good conditions for the second stage operation.