前路前段玻璃体切除术治疗青光眼白内障联合术后的恶性青光眼

发布时间：2018-03-06 14:47

本文选题：青光眼　切入点：白内障　出处：《国际眼科杂志》2016年12期 　论文类型：期刊论文

【摘要】：目的:探讨前路前段玻璃体切除术治疗青白联合术后恶性青光眼的疗效。方法:回顾性分析2010-06/2015-06间我院行超声乳化白内障摘除+人工晶状体植入联合小梁切除术后发生恶性青光眼的患者14例16眼,经保守治疗无效,采用前路前段玻璃体切除治疗:经透明角膜切口,虹膜拉钩暴露6∶00位人工晶状体复合体边缘,行前后囊膜部分切除联合相应部位前段玻璃体切除术治疗。结果:所有患者经过12mo的随访观察,治疗后前房均重建成功,平均最佳矫正视力(best corrected visual acuity,BCVA,Log MAR)由术前的0.2±0.17,提高到末次随访的0.5±0.29,差异具有统计学意义(P0.05),平均眼压由术前的42.6±4.23mm Hg至末次随访的15.89±4.72mm Hg,差异具有统计学意义(P0.05),其中2眼需用一种抗青光眼药物,2眼需用两种抗青光眼药物,其完全成功率为75%,部分成功率25%,成功率100%,平均前房深度由术前的0.62±0.23mm至末次随访的3.49±0.57mm,2眼治疗后出现睫状体脉络膜脱离,经保守治疗恢复。所有患者在随访期间均未出现角膜内皮功能失代偿、人工晶状体偏位、脉络膜上腔出血、视网膜脱离等严重并发症。结论:前路前段玻璃体切除可以有效治疗青白联合术后恶性青光眼,较后路法更简单安全、易掌握、并发症少。
[Abstract]:Objective: to investigate the effect of anterior anterior vitrectomy on malignant glaucoma after operation. Methods: retrospective analysis of phacoemulsification cataract extraction and intraocular lens implantation combined with trabeculectomy in 2010-06 / 2015-06 in our hospital. There were 14 patients with 16 eyes of malignant glaucoma. After conservative treatment, anterior anterior vitrectomy was used: through a transparent corneal incision, the iris retractor exposed the edge of the intraocular lens complex at 6:00. The anterior posterior capsule resection combined with anterior vitrectomy was performed. Results: after 12 months follow-up, the anterior chamber was reconstructed successfully. The mean best corrected visual acuteness of BCVA log Mark increased from 0.2 卤0.17 before operation to 0.5 卤0.29 at the last follow-up. The difference was statistically significant (P 0.05). The mean IOP was 42.6 卤4.23 mm Hg before operation to 15.89 卤4.72 mm Hg in the last follow-up. The difference was statistically significant in 2 eyes. Two kinds of antiglaucoma drugs are needed in 2 eyes with one kind of antiglaucoma drug. The complete success rate was 75%, the partial success rate was 25%, and the success rate was 100%. The mean anterior chamber depth was 0.62 卤0.23 mm before operation and 3.49 卤0.57 mm in the last follow-up. After conservative treatment, no corneal endothelial decompensation, intraocular lens deviation, suprachoroidal hemorrhage were found in all patients. Conclusion: anterior vitrectomy can be effective in the treatment of malignant glaucoma after combined operation, which is simpler, safer, easier to master and less complication than that of posterior approach.
【作者单位】：滨州沪滨爱尔眼科医院;
【分类号】：R779.6

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