| 青光眼术后滤过泡侵犯角膜17例临床病例分析 |
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| 引用本文： | 张宁,张文强,丁琴,刘洪,周和政. 青光眼术后滤过泡侵犯角膜17例临床病例分析[J]. 眼科新进展, 2018, 0(4): 364-367. DOI: 10.13389/j.cnki.rao.2018.0085 |
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| 作者姓名： | 张宁 张文强 丁琴 刘洪 周和政 |
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| 作者单位： | 430070 湖北省武汉市中国解放军武汉总医院，全军眼科中心 |
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| 摘 要： | 目的 报告一种滤过性手术的术后并发症——滤过泡侵犯角膜（corneal invasion of filtering bleb，CIFB），分析其诊治要点。方法 回顾性分析我院2006年3月至2017年4月收集的17例CIFB患者的临床资料，依据分型标准，对患者分型后进行治疗，治疗方法:轻型:无后界粘连者保守治疗，有后界粘连者针刺分离联合5-氟尿嘧啶滤过泡旁注射并眼球按摩；中型:无进展者同轻型，进展明显者行滤过泡部分切除并羊膜移植术；重型:角结膜滤过泡切除加板层角膜移植并滤过泡重建。最后，对其分型标准、临床特点、随访结果等进行分析和总结。结果 17例患者均为以穹隆部为基底的结膜切口；术中均使用了丝裂霉素C；CIFB发展较快者的滤过泡后界均已发生粘连，及时解除粘连可减缓或停止发展。根据入侵角膜的程度，CIFB为轻型者11例、中型者5例、重型者1例。经治疗轻型病例全部停止进展，中、重型病例术后无复发。结论 CIFB与滤过泡下坠是不同的并发症，及时识别、处置可延缓或停止角膜损害进展，保持滤过性手术的效果。
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| 关 键 词： | 抗青光眼滤过性手术 滤过泡侵犯角膜 诊断 治疗 |
Clinical analysis of 17 patients with corneal invasion of filtering blebafter anti-glaucomatous filtering surgery |
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| ZHANG Ning,ZHANG Wen-Qiang,DING Qin,LIU Hong,ZHOU He-Zheng. Clinical analysis of 17 patients with corneal invasion of filtering blebafter anti-glaucomatous filtering surgery[J]. Recent Advances in Ophthalmology, 2018, 0(4): 364-367. DOI: 10.13389/j.cnki.rao.2018.0085 |
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| Authors: | ZHANG Ning ZHANG Wen-Qiang DING Qin LIU Hong ZHOU He-Zheng |
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| Affiliation: | Ophthalmic Center，Wuhan General Hospital of the People’s Liberation Army，Wuhan 430070，Hubei Province，China |
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| Abstract: | Objective To report a postoperative complication of corneal invasion of filtering bleb(CIFB)and the analysis of its diagnosis and treatment.Methods A retrospective analysis was conducted in 17 patients with CIFB collected from March 2006 to April 2017.They were treated according to the classification standards.Patients suffering the mild type with no obvious conjunctival post-adhesion received conservative observation；but patients with obvious adhesion were given acupuncture separation combined with 5-Fluorouracil filter follicular subconjunctival injection and eye massage.The moderate type with no progress was treated with the mild and mediumpartial filtration and amniotic membrane transplantation.For the severe ones，the conjunctiva filtering bleb was excised with lamellar keratoplasty and filtering bleb reconstruction.Finally，the clinical features，classification standards and the follow-up results were summarized.Results As for the clinical features，17 patients were treated with domeas the basement of the conjunctival incision，and received intraoperative mitomycin administration.For the patients with CIFB growing rapidly，the posterior synechiae of their filtering blebs had occurred and timely actions could slow down or stop its development.As for the classification standards，according to the degree of corneal invasion，there were 11 patients being mild type，5 patients being moderate types，and only 1 patients being severe type.After treatment，the progress stopped in all mild patients，while the moderate and severe types were not relapsed after treatment.Conclusion CIFB is different from overhanging filtering bleb.As a less common kind of filtering bleb complication，timely identification and appropriate treatments can effectively delay or even stop the progress of corneal damage to maintain the filtering surgery effects. |
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| Keywords: | anti-glaucomatous filtering surgery corneal invasion of filtering bleb diagnosis treatment |
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