三联手术治疗真性小眼球继发青光眼的疗效评价

Efficacy Evaluation of Triple Surgery in the Treatment of True Small Eyeball Secondary Glaucoma(Axial Length<16 mm)

目的探讨小梁切除术联合白内障超声乳化联合预防性睫状体扁平部巩膜切开术对真性小眼球继发青光眼的临床效果及预后的影响因素。方法回顾性分析2018年6月-2020年2月我院收治的真性小眼球继发青光眼患者(眼轴<16 mm)6例,均行三联手术治疗,比较患者手术前后未矫正视力(UCVA)、最佳矫正视力(BCVA)、眼压(IOP)变化以及术中术后并发症发生情况。结果随访显示,患者平均UCVA从基线视力1.46(logMAR)提升至0.97(logMAR),差异有统计学意义(P<0.05);但手术前后BCVA比较,差异无统计学意义(P>0.05),其中眼轴、术前前房深度以及术前最佳矫正视力是术后BCVA的影响因素;术前平均眼压为(36.11±8.79)mmHg,高于治疗后的(16.61±3.09)mmHg,差异有统计学意义(P<0.05);随访期间,共5眼出现了术后并发症(55.56%)。结论三联手术治疗眼轴小于16 mm真性小眼球继发青光眼效果良好,但仍有术后并发症发生的可能。

Objective To investigate the clinical effect and prognostic factors of trabeculectomy combined with phacoemulsification combined with preventive ciliary body flat scleral resection for secondary glaucoma of true eyeball.Methods A retrospective analysis was performed on 6 patients with secondary glaucoma due to true small eyeball(axial diameter<16 mm)admitted to our hospital from June 2018 to February 2020.All patients underwent triple surgery.The changes of uncorrected visual acuity(UCVA),best corrected visual acuity(BCVA),intraocular pressure(IOP)and intraoperative and postoperative complications before and after surgery were compared.Results Follow-up showed that the average UCVA increased from 1.46(logMAR)to 0.97(logMAR),and the difference was statistically significant(P<0.05).The axial length,preoperative anterior chamber depth and preoperative best corrected visual acuity were the influencing factors of postoperative BCVA.The preoperative average intraocular pressure was(36.11±8.79)mmHg,which was higher than(16.61±3.09)mmHg after treatment,and the difference was statistically significant(P<0.05).During the follow-up period,a total of 5 eyes had postoperative complications(55.56%).Conclusion The effect of triple surgery in the treatment of secondary glaucoma in small eyeballs with ocular axis less than 16 mm is good,but there are still possible postoperative complications.