玻璃体视网膜手术后继发性青光眼的病因及治疗

Etiology and treatment of secondary glaucoma after vitreoretinal surgery

玻璃体视网膜疾病的手术治疗主要包括巩膜扣带术、玻璃体切割术、玻璃体腔注气或注油术等,均可能导致术后眼压升高,如未及时处理,可发展为继发性青光眼,导致永久视力丧失。玻璃体视网膜手术后继发性青光眼的病因复杂多样,并且此类继发性青光眼通常常规治疗效果不佳,属于难治性青光眼。根据患者的不同病因可以采用不同的治疗方法,早期青光眼主要采用药物或激光治疗,晚期青光眼多行手术治疗,然而传统的青光眼小梁切除术失败率高,青光眼引流阀植入术能有效降低眼压。本文主要对常见的四种玻璃体视网膜术后继发性青光眼的发病机制及目前国内外治疗的研究进展进行综述。

·Surgical treatment of vitreoretinal diseases,including scleral buckling,vitrectomy,and vitreous cavity gas injection or oil injection,may lead to increased intraocular pressure after surgery.If not treated promptly,it may develop into secondary glaucoma and lead to permanent vision loss.The causes of secondary glaucoma after vitreoretinal surgery are complex and varied.Different treatment methods can be used according to the different causes of the patients.Early glaucoma is mainly treated with drugs or lasers,while patients with advanced glaucoma are treated with multiple surgeries.However,the failure rate of traditional trabeculectomy is high,and glaucoma drainage valve implantation can effectively reduce intraocular pressure.This article reviews the pathogenesis of high intraocular pressure after routine vitreoretinal surgery and the current research progress in treatment at home and abroad.