先天性小眼球合并青光眼的治疗方法探讨
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Discussion on treatment plan for glaucoma with congenital microphthalmos
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    摘要:

    目的: 探讨先天性小眼球合并青光眼的治疗方案。

    方法:回顾孝感市中心医院眼科1998/2011年先天性小眼球患者10例20眼中7例14眼闭角型青光眼患者的临床资料及治疗方案,随访6~48mo。

    结果:本组小眼球患者10例20眼中未合并青光眼的3例6眼,眼压正常,未作特殊处理。闭角型青光眼患者7例14眼,初诊眼压22~40mmHg者5眼,>40mmHg者9眼。其中8眼行小梁切除术,术后眼压≤21mmHg者3眼,21~30mmHg者2眼,>30mmHg者1眼,患恶性青光眼者2眼; 6眼先行超声乳化摘除晶状体,术后3mo再行小梁切除术,术后眼压≤21mmHg者4眼,21~30mmHg者2眼,未出现恶性青光眼患者。

    结论:对于先天性小眼球合并闭角型青光眼患者,单纯行青光眼滤过手术容易因恶性青光眼而导致手术失败,眼压无法控制,如果先摘除晶状体,则可降低发生恶性青光眼的风险,提高手术成功率。

    Abstract:

    AIM: To discuss the treatment plan for glaucoma with congenital microphthalmos.

    METHODS: Clinical data and treatment plans of 10 cases affected with congenital microphthalmos(20 eyes)accepted from 1998 to 2011 at ophthalmology department of Xiaogan Central Hospital were reviewed. Follow-up visit lasted 6-47 months.

    RESULTS: All the 10 patients(20 eyes)were affected with medium and hyperpresbyopia as well as shallow anterior chamber, 14 eyes suffered closure glaucoma. After preliminary diagnosis, 5 eyes were detected with eye pressure between 22-40mmHg, 9 eyes with eye pressure>40mmHg. 8 eyes therein underwent trabeculectomy. 3 eyes were found with post-operational eye pressure ≤21mmHg, 3 eye with eye pressure between 21-30mmHg, and 2 eyes affected with malicious glaucoma. 6 eyes were treated by ultrasonic phacoemulsification and then trabeculectomy 3 months later. Then 4 eyes were detected with eye pressure ≤21mmHg and with eye pressure between 21-30mmHg. No malicious glaucoma was detected.

    CONCLUSION: For closure glaucoma with congenital microphthalmos, treatment only with glaucoma filtration surgery may easily result in failures because of malicious glaucoma and incontrollable eye pressure. To perform cataract extraction in advance will conduces to risk reduction of malicious glaucoma and enhancement of the surgery successful rate.

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李勇,徐海龙,岳章显,等.先天性小眼球合并青光眼的治疗方法探讨.国际眼科杂志, 2013,13(2):372-373.

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  • 收稿日期:2012-08-14
  • 最后修改日期:2013-01-14
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