前房穿刺时限对原发性急性闭角型青光眼大发作的预后影响

Influence of anterior chamber puncture time on prognosis of acute angle-closure glaucoma

目的评价前房穿刺时限对药物不可控制、持续高眼压状态下的原发性急性闭角型青光眼大发作的预后影响。方法回顾性分析2014年1~12月收治于华中科技大学同济医学院附属同济医院眼科的原发性急性闭角型青光眼大发作患者27例(28眼),发作眼急诊行前房穿刺放液术,术后按眼压情况即房水外流通道是否有效恢复分为A、B两组,对两组前房穿刺时限及视力转归情况进行比较。结果A组前房穿刺时限明显低于B组,差异有统计学意义(t=-7.30,P<0.01);A组视力恢复情况明显优于B组,差异有统计学意义(t=6.15,P<0.01)。结论原发性急性闭角型青光眼大发作行前房穿刺后,对房水外流通路能有效恢复、眼内压短期下降的患者,穿刺放液时限较短,视力恢复较好。

Objective To evaluate the prognostic impact of anterior chamber puncture time on the primary acute angle-closure glaucoma under drug uncontrollable and sustained high intraocular pressure.Methods A retrospective analysis of 27 patients(28 eyes)with primary acute angle-closure glaucoma treated in the ophthalmology department of Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January to December 2014 was performed.The anterior chamber puncture was performed in the affected eyes.The patients were divided into group A and group B according to the postoperative intraocular pressure,namely whether the aqueous fluid outflow channel was effectively restored or not.The anterior chamber puncture time and visual acuity outcomes of the two groups were analyzed and compared.Results The anterior chamber puncture time of group A was significantly shorter than that of group B,with statistically significant difference(t=-7.30,P<0.01).The visual recovery of group A was significantly better than that of group B,with statistically significant difference(t=6.15,P<0.01).Conclusion After the implementation of anterior chamber puncture in the patients with acute angle-closure glaucoma,the patients with effective recovery of aqueous fluid outflow channel and short-term intraocular pressure reduction have shorter puncture drainage time and better visual recovery.