玻璃体切割术后（水眼）继发青光眼的手术治疗策略-《眼科新进展》

文章信息/Info

Author(s):: GAO Yu-Wei; ZHANG Shu-Xin ; SUN Li ; ZHANG Xin-Fang; Beijing Eye Huade Hospital ,Beijing 100026 , China

摘要:: 目的　评估玻璃体切割术后（水眼）继发青光眼患者的手术治疗方法。方法　回顾性分析我院２０１３年１０月至２０１４年４月收治的玻璃体切割术后（水眼）继发青光眼患者２６例２６眼的临床资料，对所有患者进行复合式小梁切除术，术中采用预置缝线，术后随访１２个月，观察视力、眼压及并发症情况。结果　末次随访时，视力、眼压均较术前改善，差异均有统计学意义（均为Ｐ＜０．０５）；２０眼获得了满意效果，６眼术后眼压回升，加用降眼压药物后４眼控制在正常范围，２眼眼压失控，再次行睫状体二极管光凝术，术后眼压正常。结论　复合式小梁切除术，术中采用预置缝线，对玻璃体切割术后（水眼）继发青光眼患者是一种安全有效的手术方式，可以在很大程度上减少术中暴发性脉络膜出血及术后脉络膜脱离的发生几率。

Abstract:: Objective To evaluate the surgical strategies for glaucoma secondary to vitrectomy. Methods A retrospective review was performed in 26 patients ( 26 eyes) with glaucoma secondary to vitrectomy in our hospital from October 2013 to April 2014 , all cases underwent the combined trabeculectomy. Intraoperative preset suture was used in all of the patients. The follow-up time was 12 months . the visual acuity , intraocular pressure (IOP) and complications were observed. Results At the final follow-up , the visual acuity and IOP were improved .there were statistical differences compared with pre-operation ( all P < 0. 05 ) ;The surgical effects in 20 eyes were satisfactory , the postoperative IOP in 6 eyes increased.the decreased IOP drugs were given , then IOP in 4 eyes were returned to normal.another 2 eyes were uncontrolled to perform the ciliary body diode photocoagulation, and the postoperative IOP were returned to normal. Conclusion Combined trabeculectomy with intraoperative preset suture is effective in treating glaucoma secondary to vitrectomy, can largely reduce the incidence of intraoperative explosive choroid bleeding and postoperative choroid detachment.