摘要
目的探讨玻璃体切除术对治疗继发性青光眼的疗效。方法对16例继发性青光眼联合应用玻璃体切除治疗。常规球后、眼轮匝肌浸润麻醉,4例从角膜缘入前房行前段玻璃体切除及前房积血吸出;12例采用经睫状体平坦部三通道玻璃体切除术,充分切除玻璃体,其中6例同时行晶状体切除,2例新生血管青光眼联合小梁切除术。结果①视力:16例患者中,术后12例视力有不同程度提高。其中8例由眼前手动提高到0.2—0.4。2例由0.01～0.04提高到0.2-0.4,另2例由0.1提高到0.5。有4例因眼外伤严重,角膜血染、眼底出血、视神经萎缩等至视力无提高;②眼压:术后眼压13例控制在正常范围,3例术后眼压轻度增高4.2～5.6mmHg,给予降眼压药物治疗眼压降至正常。术后6～8d眼压控制在平均18.4 mmHg。随访1—10(平均5月),眼压仍控制在17.3-19.8mmHg。③并发症:术后常见并发症有眼内出血,低眼压。结论联合玻璃体切除术对治疗继发性青光眼是一种有效的治疗方法。
Aim To determine the effect of vitrectomy in treatment of secondary glaucoma. Methods For 16 cases of secondary glaucoma, vitrectomy was performed. Routine retrobulbar anaesthesia and infiltration anesthesia of orbicularis were induced first. For 4 patients, anterior-segment vitrectomy was performed via corneal limbus-anterior chamber approach. For the other 12 patients, vitrectomy was performed via three canals in the pars plana of ciliary body and of them, 3 had lensectomy simutaneously and 2 with neovascular glaucoma had trabeculectomy in the mean time. Results Out of the 16 patients, vision improved differently after the operation in 12, from hand moving to 0.2-0.4 in 8, from 0.01-0.04 to 0.2-0.4 in 2 and from 0.1 to 0.5 in 2. In the other 4 patients, vision could not recover due to severe eye trauma, comeal bleeding, retinal hemorrhage, optic atrophy, etc. After the operation, intraocular pressure (IOP) was controlled within the normal range in 13 patients and in the other 3, rose slightly by 4.2-5.6 mmHg, which was brought to normal after topical application of antiglaucoma drugs. IOP averaged 18.4 mmHg at 6-8 days after operation and maintained at 17.3-19.8 mmHg during a follow-up of 1-10 months (mean, 5 months). Major postoperative complications included intraocular bleeding and hypotomy. Conclusion Vitrectomy is effective for secondary glaucoma.
出处
《国际眼科杂志》
CAS
2003年第3期94-95,共2页
International Eye Science
