摘要
目的 探讨青光眼滤过术后发生脉络膜脱离的相关因素和预防措施。方法 对 3 3 7例 ( 3 78眼 )青光眼滤过手术后发生脉络膜脱离的 8例 ( 10眼 )的临床资料进行回顾性分析。结果 8例 ( 10眼 )发生脉络膜脱离的患者中急性闭角型青光眼 3例 ( 3眼 ) ,慢性闭角型青光眼 4例 ( 6眼 ) ,新生血管性青光眼 1例 ( 1眼 ) ;年龄 5 1～ 73岁 ,平均 ( 65 2 5± 5 5 8)岁 ;8例患者中 1例患有原发性高血压 ,4例患有 2型糖尿病 ,其中 3例糖尿病患者合并有高血压。 3例 ( 4眼 )术前用药物将眼压控制到接近正常水平 ( 2 2 3 8～ 2 4 3 8mmHg) ,5例 ( 6眼 )在高眼压 ( 3 5 76～ 5 0 10mmHg)下手术。脉络膜脱离发生时间 1～ 11d ,平均 ( 5 2 5± 2 2 )d。 6眼经药物保守治疗后 ,浅前房恢复时间为 5～ 10d ,平均 ( 7 5± 1 0 4)d ,4眼经手术治疗后 ,浅前房恢复时间为术后 1～ 6d ,平均 ( 3 67± 1 45 )d。结论 青光眼滤过术后脉络膜脱离的发生与术前高眼压、糖尿病、高血压、动脉硬化等多种因素有关。尽量降低术前眼压 ,避免和减轻术中眼压骤降情况 ,术毕时形成前房 ,外置可拆除巩膜瓣缝线 ,术后应用皮质激素和睫状肌麻痹剂 ,避免精神紧张 。
Objective To investigate the related factors and the preventive measures of choroidal detachment after glaucoma filtering surgery. Methods The clinical data of 8 patients (10 eyes) with choroidal detachment out of 337 patients (378 eyes) undergoing glaucoma filtering surgery were analyzed retrospectively. Results Of the 8 patients (10 eyes) with choroidal detachment, acute angle closure glaucoma was found in 3 patients (3 eyes), chronic angle closure glaucoma in 4 patients (6 eyes), and neovascular glaucoma in 1 patient (1 eye). The youngest was 51 years old and the oldest was 73 years old with an average age of (65.25±5.58) years old. Of the 8 patients, primary hypertension was found in 1 patient, type Ⅱ diabetes in 4 patients (diabetes patients combined with hypertension in 3 out of the 4 patients). Intraocular pressure of 3 patients (4 eyes) was regulated to the normal level [(22.38-24.38) mmHg] by medicine before operation. The remaining 5 patients (6 eyes) underwent operation at high intraocular pressure [(35.76-50.10) mmHg]. Choroidal detachment occurred at 1-11 d, (5.25±2.2) d in average. Shallow anterior chambers of 6 eyes treated by medicine therapy recovered within 5-10 d, (7.5±1.04) d in average. Shallow anterior chamber of 4 eyes treated by surgery recovered within 1-6 d, (3.65±1.45) d in average. Conclusion Occurrence of the choroidal detachment after glaucoma filtering surgery is associated with many factors, such as high intraocular pressure before operation, diabetes, hypertension, and arteriosclerosis. The preventive measures of choroidal detachment after glaucoma filtering surgery include: controlling intraocular pressure as low as possible before operation, avoiding sudden reduced intraoculer pressure during operation, forming anterior chamber at the end of operation, using releasable scleral flap sutures, adopting corticosteroid and ciliary muscle anaesthetics after operation, and avoiding mental stress.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2004年第8期733-735,共3页
Journal of Third Military Medical University
关键词
青光眼滤过术
脉络膜脱离
相关因素
预防措施
glaucoma filtering surgery
choroidal detachment
relative factor
preventive measure
