摘要目的 评价原发性急性闭角型青光眼持续高眼压状态下行小梁切除术的治疗效果.方法 回顾性分析2016年3月至2017年10月原发性急性闭角型青光眼79例(82眼)的临床资料.其中观察组40例(41眼)术前经常规降眼压治疗后眼压仍为≥40 mmHg(1 mmHg=0.133 kPa);且持续3天以上.对照组39例(41眼),术前眼压控制至<40 mmHg以下.两组均行小梁切除术.观察两组的手术效果和术后并发症发生率.结果 观察组术后3个月视力较术前提高、不变和下降的比例分别为78.05％、17.07％、和4.88％,与对照组比较差异无统计学意义(Z=1.620,P=0.110);两组术后眼压均较术前明显降低,差异有统计学意义(P<0.05).术后早期观察组高眼压发生率大于对照组,差异有统计学意义(χ2=4.100,P=0.042);而术后3个月两组眼压控制情况比较差异无统计学意义(t=1.309,P=0.194).观察组术后并发症发生率为36.6％,对照组并发症发生率7.3％,差异有统计意义(χ2=10.250,P=0.001).结论 对持续高眼压状态下的急性闭角型青光眼行小梁切除术可以有效地降低眼压保留患者视功能,但并发症较多,须积极处理.

abstractsObjective To evaluate the efficacy of trabeculectomy in primary acute angle-closure glaucoma patients with sustained intraocular hypertension. Methods The data of 82 eyes of 79 patients of primary acute angle-closure glaucoma from Mar. 2016 to Oct. 2017 were analyzed retrospectively. The patients were divided into two groups:the observation group, 41 eyes of 40 patients, with IOP ≥40 mmHg and lasted for more than 3 days after conventional treatment and the control group,41 eyes of 39 patients, with IOP<40 mmHg. The two groups were treated with trabeculectomy. The follow up time was 3 months. The surgical efficacy and postoperative complications were compared and analysed. Results The improved, unchanged and decreased rate of visual acuity in observation group at 3 months postoperatively were 78. 05％,17. 07％ and 4. 88％, the difference were not statistically significant between the two groups (Z=1.620,P=0. 110). The postoperative IOP of the two groups significantly decreased (P <0. 05). The incidence of intraocular hypertension of observation group was higher significantly than control group at early stage after operation(χ2 =4. 100,P =0.042). The differences of IOP between the two groups was not statistically significant at 3 months postoperatively(t=1. 309, P=0. 194). Postopertive complication rate of observation group was 36. 6％, and the control group was 7. 3％. The difference between the two groups was statistically significant(χ2 =10. 250 P =0. 001). Conclusion Trabeculectomy is safe and effective for primary acute angle-closure glaucoma patients with sustained intraocular hypertension, the complications should be treated actively.