持续高眼压状态下青光眼手术探讨

Research on glaucoma operation in persistent ocular hypertension.

目的 探讨持续高眼压青光眼的手术治疗的注意事项。方法 对55例61眼高眼压青光眼用各种药物降低眼压后,进行巩膜下咬切+虹膜周切或全切,小梁切除术,青光眼滤过手术+白内障囊外摘出术。术前尽量降低眼压,减轻葡萄膜反应;术中减少对组织的损伤,切开前房时,缓慢放出房水;术后密切观察前房深度、葡萄膜反应及眼压,及时对症处理。结果 术后1月眼压<20mmHg占85％,21-25mmHg4眼,26-30mmHg5眼(1mmHg=0.133kPa);视力提高者32眼,占52％,无变化13眼,下降16眼。结论 持续高眼压状态下青光眼手术可以挽救大部分患者的视功能,但须在术前、术中及术后采取缜密措施。

Objective To research the notices in persistent ocular hypertent-sion glaucoma surgeries. Methods After using various medicines to reduce the ocular tension,55 patients (61 eyes) with persistent ocular hypertension were performed by trabeculectomy, trabeculectomy + extracap-sular cataract extration. Before operation, try to depress ocular tension, control uveitis. During operation make the aqueous humor to flow out slowly. After operation, pay attention to reaction of uvea, the deaph of anterior chamber and ocular tension, and treat them in time. Results After a month of operation, the ocular tension of 52 eyes was less than 20 mmHg (85%),4 eyes was 21 ~ 25 mmHg,5 eyes was 26 ~ 30 mmHg (1mmHg = 0.133kPa) .The Visual acuity improved obviously in 32 eyes, visual acuity remained unchange in 13 eyes,visual acuity deteriorated in 16 eyes. Conclusion The operation may restore the visual function of most patients with persistent ocular hypertension glaucoma.