青光眼滤过手术后浅前房的观察及处理
Observation and therapy of shallow anterior chamber formed after trabeculectomy in patients with glaucoma
摘要目的 探讨青光眼滤过术后浅前房的发生原因及处理方法.方法 分析施行穿透性或非穿透性小梁手术的青光眼患者共158例(186眼)的术后情况.结果 ①术后浅前房:穿透性小梁手术组(93例)32眼,发生率34.41%;非穿透性小梁手术组(93例)3例,发生率为3.23%,两组差异有显著统计学意义(χ2=7.891,P=0.003);②浅前房的原因:35例浅前房中,脉络膜脱离20眼(占57.14%),引流过畅8眼(22.86%),房水生成不足4眼(11.43%),结膜渗漏2眼(5.71%),恶性青光眼1眼(2.86%);③浅前房发生的多因素分析表明,与青光眼类型(回归系数β=4.214,P<0.01)及年龄(β=5.176,P<0.01)有显著相关性,与性别(β=0.363,P=0.859)无关.结论 非穿透小梁切除术可显著降低浅前房的发生率;术者应注意浅前房的易发因素以降低术后浅前房发生率.
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abstractsObjective To analyze the cauls for the formation of shallow anterior chamber after trabe-culectomy in patients with glaucoma and its treatment. Methods A total of 186 eyes of 158 subjects with glau-coma who underwent penetrating and non-penetrating trabeculectomy were reviewed retrospectively. Results Shallow anterior chamber occurred in 32 eyes (32/93,34.41%) in penentrating trabeculectomy group,3 eyes (3/93,3. 23%) in non-penetrating trabeculectomy group. Choroidal detachment (20, 57.17%), excessive drainage through filtration track (8,22.86%), low production of aqueous humor (4,11.43%), the leakage of chamber fluid (2,5.71%) and malignant glaucoma (1.2.86%) were the main causes for the development of shallow anterior chamber postoperatively. The correlations between the development of shallow anterior chamber and the type of glaucoma (β=4.214, P<0.001), and age (β=5.176, P<0.001) were statistically signifi-cant. It was not associated with gender (β=0.363, P=0.859). Conclusion Non-penetrating trabeculectomy is a safe technique that significantly reduces the incidence of immediate postoperative shallow anterior chamber. Attention should be paid to the risk factors of the development of shallow anterior chamber postoperatively.
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