COVID-19爆发期武汉原发性急性闭角型青光眼的手术治疗

Surgical treatment of primary acute angle-closure glaucoma during COVID-19 disease outbreak in Wuhan

目的:总结新型冠状病毒肺炎(COVID-19)疫区原发性急性闭角型青光眼患者的特点和救治方法。方法:回顾性分析2020-03-02/20疫情期间我院治疗的原发性急性闭角型青光眼患者5例9眼的病历资料,慢性进展期8眼施行白内障超声乳化人工晶状体植入联合房角分离术,临床前期1眼施行激光虹膜周切术。分析手术前后眼压、视力及并发症等情况,总结患者特点及诊治体会。结果:原发性急性闭角型青光眼患者5例中3例为双眼发病,发病时间12~40(25.2±11.82)d;白内障超声乳化人工晶状体植入联合房角分离术后眼压(12.63±1.68mmHg)较术前(48.38±3.22mmHg)明显下降(t=12.192,P<0.01);住院天数2~6(平均3.8±1.48)d。5例患者均未发现感染及手术相关并发症。结论:在COVID-19疫情期间,疫区原发性急性闭角型青光眼慢性进展期患者发作时间长、病情重,双眼发作比例高;白内障超声乳化人工晶状体植入联合房角分离术可以安全、有效地降低原发性急性闭角型青光眼患者的眼压;疫情期间规范的防控措施可有效保障医患安全,但加大手术难度。

AIM:To summarize the characteristics and treatment of primary acute angle-closure glaucoma during the outbreak of corona virus disease 2019(COVID-19)in Wuhan.METHODS:Five patients(9 eyes)with primary acute angle-closure glaucoma(APACG)of our hospital were enrolled.Eight eyes with sustained high intraocular pressure(IOP)were given phacoemulsification with goniosynechialysis and one eye in preclinical phase was given YAG laser iridectomy from March 3-20,2020.The preoperative and postoperative IOP,visual acuity,hospitalization days and complications were reviewed and analyzed.RESULTS:Three out of five APACG cases were binocular attack.The onset time was 12-40(25.2±11.82)d.The IOP(48.38±3.22mmHg)of eight eyes decreased significantly after surgeries(12.63±1.68mmHg),the difference was statistically significant(t=12.192,P<0.01).The hospitalization time was 2-6(3.8±1.48)d.No COVID-19 infection or severe complications were observed.CONCLUSION:During the epidemic of COVID-19,phacoemulsification with goniosynechialysis is able to reduce IOP of APACG patients who suffered from longer,heavier and binocular attack in the epidemic area effectively and safely.Strict prevention management can effectively ensure the safety of medical staff and patients,but also increase the difficulty of the surgeries meanwhile.