目的探讨针拨联合丝裂霉素C(MMC)球结膜下注射治疗新生血管青光眼小梁切除术后功能不良滤过泡的疗效。方法对25例(25只眼)因新生青光眼行小梁切除术后滤过泡功能不良者,进行针拨联合MMC0.2 m l(0.04 mg)球结膜下注射,观察视力、眼压、...目的探讨针拨联合丝裂霉素C(MMC)球结膜下注射治疗新生血管青光眼小梁切除术后功能不良滤过泡的疗效。方法对25例(25只眼)因新生青光眼行小梁切除术后滤过泡功能不良者,进行针拨联合MMC0.2 m l(0.04 mg)球结膜下注射,观察视力、眼压、滤过泡和副作用,并随访6～12个月。结果小梁切除术后低平限局肥厚充血型18只眼、包囊型囊样7只眼。针拨联合MMC结膜下注射治疗后6～12个月,轻度膨隆弥散型11只眼,多腔或薄壁型8只眼,限局肥厚型或无滤过泡6只眼。治疗前患眼的眼压为(32.5±5.5)mm Hg,随访结束时具有功能滤过泡眼的眼压为(18.2±3.4)mm Hg。与针拨前比较两者差异有统计学意义(P<0.05)。19只眼眼压下降有效,成功率占75%。治疗后结膜下出血3只眼,前房出血5只眼,无低眼压、伤口渗漏和脉络膜渗漏及浅前房等并发症。结论针拨联合MMC结膜下注射治疗新生血管性青光眼小梁切除术后功能不良滤过泡是安全、有效、简单的方法。展开更多
A 62-year-old woman with neovascular glaucoma underwent filtering surgery with the Ahmed glaucoma valve (New World Medical,Inc.,Rancho Cucamonga,CA). Intraoperative hypotony secondary to a defective valve was noted an...A 62-year-old woman with neovascular glaucoma underwent filtering surgery with the Ahmed glaucoma valve (New World Medical,Inc.,Rancho Cucamonga,CA). Intraoperative hypotony secondary to a defective valve was noted and managed by excising the valve mechanism. The implant was then treated as if it was non-valved by placement of an obturator suture. The postoperative course was unremarkable for a non-valved implant. This case demonstrates how intraoperative hypotony secondary to overfiltration of an Ahmed glaucoma valve implant can be successfully managed by converting to a non-valved implant.展开更多
目的:探讨原发性开角型青光眼(primary open angle glaucoma,POAG)患者血管内皮功能及血液流变学指标变化及危险因素分析。方法:POAG患者86例作为研究对象(观察组),依据视野缺损程度分为轻度组(n=27)、中度组(n=29)和重度组(n=30),另选...目的:探讨原发性开角型青光眼(primary open angle glaucoma,POAG)患者血管内皮功能及血液流变学指标变化及危险因素分析。方法:POAG患者86例作为研究对象(观察组),依据视野缺损程度分为轻度组(n=27)、中度组(n=29)和重度组(n=30),另选取正常健康体检者30例作为对照组,分析POAG的危险因素及各组间血管内皮功能及血液流变学水平。结果:单因素分析结果指出,对照组与观察组间患者性别比例、平均年龄、酗酒史及心血管病史比较,差异无统计学意义(P>0.05),吸烟史、高血压史、糖尿病史及家族史比较,差异均具有统计学意义(P<0.05);观察组一氧化氮(nitric oxide,NO)水平显著低于对照组,且重度组水平显著低于中度组,重度组及中度组NO水平均显著低于轻度组,差异均有统计学意义(P<0.05);与对照组水平相比,观察组内皮素-1(endothelin-1,ET-1)、血浆粘度(plasma viscosity,PV)、红细胞压积(hematocrit,HCT)及纤维蛋白原(fibrinogen,FIB)水平均显著升高,且重度组ET-1、HCT水平显著高于中度组,重度组及中度组ET-1、HCT水平均显著高于轻度组,重度组PV及FIB水平显著高于轻度组,差异均有统计学意义(P<0.05);Logistic回归分析结果表明,吸烟史、高血压史、糖尿病史、家族史、ET-1、PV、HCT及FIB是原发性青光眼的危险因素,NO是保护因素(P<0.05)。结论:POAG患者存在血管内皮功能损伤及血液流变学异常,吸烟史、高血压史、糖尿病史、家族史均与POAG的发生有关。展开更多
文摘A 62-year-old woman with neovascular glaucoma underwent filtering surgery with the Ahmed glaucoma valve (New World Medical,Inc.,Rancho Cucamonga,CA). Intraoperative hypotony secondary to a defective valve was noted and managed by excising the valve mechanism. The implant was then treated as if it was non-valved by placement of an obturator suture. The postoperative course was unremarkable for a non-valved implant. This case demonstrates how intraoperative hypotony secondary to overfiltration of an Ahmed glaucoma valve implant can be successfully managed by converting to a non-valved implant.
