[1]邵珺,姚勇. 23G微创玻璃体切割术应用于恶性青光眼的诊疗思路及疗效分析[J].眼科新进展,2015,35(6):546-548.[doi:10.13389/j.cnki.rao.2015.0148]
　SHAO Jun,YAO Yong. Efficacy of 23G minimally invasive vitrectomy for malignant glaucoma[J].Recent Advances in Ophthalmology,2015,35(6):546-548.[doi:10.13389/j.cnki.rao.2015.0148]
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 23G微创玻璃体切割术应用于恶性青光眼的诊疗思路及疗效分析
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
35卷
期数:
2015年6期
页码:
546-548
栏目:
应用研究
出版日期:
2015-06-05

文章信息/Info

Title:
 Efficacy of 23G minimally invasive vitrectomy for malignant glaucoma
作者:
 邵珺; 姚勇
 214000　江苏省无锡市，南京医科大学附属无锡人民医院眼科
Author(s):
 SHAO Jun; YAO Yong
 Department of Ophthalmology,Wuxi People’s Hospital Affiliated to Nanjing Medical University,Wuxi 214000, Jiangsu Province, China
关键词:
 ; 23G; 玻璃体切割术; 恶性青光眼
Keywords:
 ; 23G ;  vitrectomy ;  malignant glaucoma
DOI:
10.13389/j.cnki.rao.2015.0148
文献标志码:
A
摘要:
 目的　探讨利用２３Ｇ微创玻璃体切割术治疗恶性青光眼的疗效，分析恶性青光眼的诊疗思路。方法　恶性青光眼患者１７例（１７眼），根据病因分为原发性和继发性。原发性恶性青光眼采用２３Ｇ玻切头前段玻璃体切割＋白内障摘除＋小梁切除＋后囊截开术，继发性采用２３Ｇ玻切头前段玻璃体切割＋白内障摘除＋后囊截开术，术后观察眼压、前房变化及术后并发症。结果　３个月的随访过程中，原发性青光眼组患者眼压均降至（１５．２８±２．６５）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍ-Ｈｇ），与术前差异有统计学意义（Ｐ＜０．０５）；继发性青光眼组降至（１２．８０±３．５４）ｍｍＨｇ，较术前降低（Ｐ＜０．０５）。原发及继发性恶性青光眼术前房角深度分别为（１．０１±０．１２）ｍｍ、（１．０２±０．３２）ｍｍ，术后前房深度分别增至（２．２７±０．０３）ｍｍ、（２．４５±０.０５）ｍｍ，术后较术前明显加深（Ｆ＝９．２８，Ｐ＜０．００１；Ｆ＝１０．１７，Ｐ＜０．００１）。术后视力较术前明显提高，无严重术后并发症发生。结论　２３Ｇ微创玻璃体切割术的应用及针对性地采取有效的联合手术方法，可以有效治疗恶性青光眼。对高危因素早诊断、早发现可有效降低青光眼术后恶性青光眼的发生率。
Abstract:
 Objective To investigate the efficacy of 23G nur血lally vitrectomy for malignant glaucoma , and analyze the treatment ideas for malignant glaucoma. Methods Seventeen malignant glaucoma patients ( 17 eyes) were divided into primary group and secondary group. Primary group received anterior vitrectomy using 23G vitrectomy, cataract extraction. trabeculectomy combined with posterior capsule cut surgery, and the secondary group received anterior vitrectomy using 23G vitrectomy , cataract extraction combined with posterior capsular cut surgery. Intraocular pressure . anterior chamber changes and postoperative complications were observed after operation. Results In the three-month follow-up ,intraocular pressures of primary patients were reduced to ( 15. 28 +2. 65 ) mmHg ( I kPa = 7. 5 mmHg) , there was statistical difference compared with pre-operation (P <0. 05 ) . and the secondary patients reduced to ( 12. 80 + 3. 54 ) mmHg , there was statistical difference compared with pre-operation ( P < 0. 05 ) . The preoperative anterior chamber angle thickness of primary and secondary patients were ( 1. 01 +0. 12) mm and ( 1. 02 + 0. 32 ) mm , respectively , the postoperative were ( 2. 27 + 0. 03 ) mm and ( 2. 45 + 0. 05 ) mm, respectively, there were significant differences ( F = 9. 28 ,P < 0. 001 ; F = 10. 17 .P < 0. 001 ) . Surgeon visual acuity improved significantly , no serious postoperative complication appeared. Conclusion 23G vitrectomy combined with targeted effectively surgical method can effectively treat malignant glaucoma. Risk factors early found and early diagnosis may be effectively reduce the incidence of malignant glaucoma after glaucoma surgery.

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备注/Memo

备注/Memo:
 江苏省自然科学基金资助项目（编号：ＳＢＫ２０１２２２０７３）；医管中心联合攻关项目（编号：ＹＧ-ＺＸ１２０６）
更新日期/Last Update: 2015-06-01