玻璃体抽吸联合前房注气术治疗浅前房急性闭角型青光眼
Vitreous aspiration combined with intracameral air injection for acute angle-closure glaucoma with extremely shallow anterior chamber
摘要目的 探讨玻璃体抽吸联合前房注气术在极浅前房的急性闭角型青光眼持续性高眼压治疗中的作用.方法 回顾性分析在2010~2012年邢台市眼科医院收治的前房极浅的急性闭角型青光眼患者共15例15只眼,常规药物治疗24 h后眼压仍>60 mmHg,在局部麻醉下于睫状体平坦部行玻璃体抽吸联合前房注气术治疗,比较手术前后眼压、视力、房角情况.结果 患者15例15只眼术前眼压均>60 mmHg,视力为光感-0.02.术后第1d眼压<21 mmHg者13只眼(87%),21~30 mmHg者2只眼(13%);术后视力0.2~0.5为10只眼(67%),视力0.1~0.2的4只眼(27%),视力<0.1的1只眼(7%);房角开放4~11个钟点不等,其中开放>6个钟点的有11只眼(73%).结论 玻璃体抽吸能显著地降低眼压,前房注气术可有效开放房角,二者结合使患者得到及时、有效的治疗,为各种青光眼手术的实施提供安全可靠的条件,值得在临床上应用.
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abstractsObjective To explore the efficiency of vitreous aspiration and intracameral air injection for acute angle-closure glaucoma with extremely shallow anterior chamber and persistent ocular hypertension.Methods Retrospective analyzed 15 eyes of angle closure glaucoma with extremely shallow anterior chamber in 15 patients.The intraocular pressure was above 60mmHg after 24 hours of routine therapy.The patients underwent vitreous aspiration via pars plana combined with intracameral air injection under local anesthesia.Pre-operation and post-operation intraocular pressure,visual acuity,angle of anterior chamber was recorded and compared.Results The intraocular pressure of 15 eyes in 15 cases of patients was all above 60mmHg,the visual acuity ranged from light perception to 0.02.In the first day after operation,The intraocular pressure in 13 eyes were under 21mmHg,2 eyes were ranged from 21mmHg to 30mmHg,10 cases of visual acuity ranged from 0.2 to 0.5,4 eyes from 0.1 to 0.2,the angle opens from 4 to ll o'clock,there were 11 eyes above 6 o'clock.Conclusions Vitreous aspiration can decrease intraocular hypertension,protect visual function markedly,and provide safe condition for various operations for glaucoma.Intracamel injection can open chamber angle efficiently,reduce the rate of filtering surgery.Vitreous aspiration combined with intracameral air injection can provided the patients efficient and timely therapy which worthy of recommending in clinical application.
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