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1.
目的探讨闭角型青光眼术后并发睫状环阻滞性青光眼的护理方法。方法20例(20眼)原发性闭角型青光眼术后并发睫状环阻滞性青光眼患者行药物或手术治疗。同时对其进行心理护理及治疗过程中的护理。结果20例患者出院后均获随访,随访时间1、3、6个月。20例患眼前房深度均形成良好,眼压均控制在正常范围内,术眼症状完全改善。结论科学有效的护理措施是达到原发性闭角型青光眼术后并发睫状环阻滞性青光眼患者预期治疗目标的重要保证。  相似文献   

2.
目的探讨眼内窥镜激光系统在无后囊支撑的无晶体性青光眼中的应用疗效。方法经药物治疗无效的无后囊支持的无晶体性青光眼22眼,比较术前与术后眼压、视力、术中及术后并发症等指标。结果术前平均眼压45mmHg,术后随诊平均6月,平均眼压18.0±9.3mmHg;术后视力均较术前有不同程度的改善。结论眼内窥镜下睫状突光凝联合人工晶体睫状沟植入术,手术直观,定位准确,并发症少,对无后囊支撑的无晶体性青光眼有理想的疗效。  相似文献   

3.
目的探讨外伤性晶状体全脱位的致伤因素、临床特点、手术治疗效果及并发症。方法对25例(25眼)外伤性晶状体全脱位患者的临床资料进行回顾性分析。结果 25例(25眼)患者主要致伤原因是石块或木块崩伤;最常见合并继发性青光眼和外伤性瞳孔散大,同时可合并房角后退,睫状体渗漏(或离断),葡萄膜炎,锯齿缘离断,以及视网膜脱离等。16例行晶状体玻璃体切除联合人工晶状体睫状沟固定术,9例行晶状体玻璃体切除术,未一期植入人工晶状体。术前矫正视力为光感~0.2,眼压8~49 mmHg,平均眼压19.2 mmHg。16例联合人工晶状体睫状沟固定手术患者术后1周矫正视力为光感~0.5,眼压9~23 mmHg,平均眼压15.6 mmHg。人工晶状体位正,无明显倾斜及偏位。9例行晶状体玻璃体切除术术后一周矫正视力为光感~指数,眼压10~19 mmHg,平均眼压13.0 mmHg。结论石块或木块崩伤是外伤性晶状体全脱位的主要致伤原因。常见合并继发性青光眼和外伤性瞳孔散大。晶状体玻璃体切除联合人工晶状体睫状沟固定术是治疗外伤性晶状体全脱位的有效方法。  相似文献   

4.
急性高眼压症的特殊护理   总被引:2,自引:0,他引:2  
急性高眼压症多因急性闭角型青光眼 ,睫状环阻滞性青光眼及某些继发性青光眼所致。患者有剧烈的眼胀痛、头痛、恶心、呕吐 ,伴有明显的视力下降 ,因此患者痛苦难忍[1] 。对 62例急性高眼压症患者的进行特殊护理 ,现总结如下。1 临床资料我院 2 0 0 0年 5月~ 2 0 0 1年 5月治疗急性高眼压患者62例。其中 ,急性闭角型青光眼 3 8例 ,男 13例 ,女 2 5例 ,年龄为 5 0~ 70岁。睫状体阻滞性青光眼 6例 ,男 2例 ,女 4例。年龄为 5 0~ 60岁。继发性青光眼 18例 ,男 10例 ,女 8例。年龄 13~ 5 8岁。2 护理2 1 入院后的护理2 1 1 心理护理。…  相似文献   

5.
现将急性视网膜坏死初诊误诊为青光眼睫状体炎综合征1例分析如下。 1病历要 女,36岁。因左眼红、胀痛、视力下降20d于2006—02-21以青光眼睫状体炎综合征(左)收住院。无诱因于20d前起左眼红、胀痛,视力下降。无其他不适,曾在当地医院按“红眼病”治疗无好转,1周前至本院门诊就诊,检查视力右眼1.0,左眼0.8,左眼睫状充血,角膜后羊脂状KP,房闪阳性。瞳孔轻度散大,光反射迟钝,左眼眼压23.24mmHg,右眼11mmHg,眼底检查未记录。诊断;青光眼睫状体炎综合征(左)。给迪非眼液、典殊眼液、迪立见眼液、毛果芸香碱眼液、美开朗眼液点眼治疗,治疗4d病情无好转,前述症状加重,住院治疗。  相似文献   

6.
[目的]探讨外伤性晶体脱位继发青光眼的临床特点以及手术治疗效果。[方法]对本院收治的32例外伤性晶体脱位继发青光眼患者作为研究对象,并对患者采用手术治疗,对患者的临床预后、眼压以及视力恢复情况进行分析。[结果]患者术后视力有明显的改善,术前、术后1周、1个月以及3个月矫正视力分别为(0.082±0.08)、(0.28±0.14)、(0.24±0.39)、(0.32±0.16),各时间点矫正视力比较具有统计学差异(P<0.05);患者术前、术后1周、1个月、3个月以及半年眼压分别为(45.83±12.12)mmHg、(17.31±3.43)mmHg、(28.93±4.34)mmHg、(18.25±3.92)mmHg、(17.23±4.34)mmHg,比较发现术后1个月眼压出现升高,但是随访发现眼压得到明显的控制。[结论]对外伤性晶体脱位继发青光眼保守治疗无效情况下采用联合手术治疗,其具有良好的临床效果以及安全性。  相似文献   

7.
目的探讨持续高眼压下急性闭角型青光眼小梁切除术的临床疗效。方法回顾分析30例患者的临床资料。结果30例30眼中,除因长时间处于高眼压而使瞳孔未能恢复外均未出现明显的并发症。术后1周眼压在7~10mmHg。6个月后复查眼压均控制在15.85—22.35mmHg之间。视力:〈0.1者5例5眼,0.1—0.3者21例21眼,0.4~0.6者4例4眼。结论对于应用药物治疗不能有效控制眼压的青光眼患者,为了避免对视神经等眼组织功能的进一步损害,有必要在持续高眼压状态下手术治疗。本组观察表明,持续高眼压下急性闭角型青光眼行小梁切除术安全有效,对持续原发性闭角型青光眼应积极采用手术治疗,术中应重视手术技巧,以挽救患者的视力。  相似文献   

8.
200205/2007—11笔者收治原发性睫状环阻滞性青光眼4例,现将诊治体会报告如下。  相似文献   

9.
200205/2007—11笔者收治原发性睫状环阻滞性青光眼4例,现将诊治体会报告如下。  相似文献   

10.
《现代诊断与治疗》2017,(9):1586-1588
目的分析睫状环阻塞性青光眼患者临床治疗方法及治疗效果。方法随机选取所在医院24例睫状环阻塞性青光眼患者作为观察组,采用手术+药物联合疗法进行治疗。同时,选取同期24例单纯采用药物进行治疗的睫状环阻塞性青光眼患者,将其作为对照组。对两组患者临床临床治疗效果及疾病复发情况做出比较。结果观察组治疗后前房深度形成良好,且眼压控制情况明显优于对照组,两组疗效存在明显差异(P<0.05);观察组前房渗出表现、虹膜粘连表现、积血表现均明显改善,随访期间无显著合并症及复发病例,治疗效果优于对照组,两组具有显著差异(P<0.05)。结论手术+药物联合疗法治疗睫状环阻塞性青光眼,临床效果明显,能够改善患者视力,并减少几率,对患者良好预后具有促进作用,值得临床广泛使用及推广。  相似文献   

11.
This study was undertaken to evaluate the ocular hypotensive efficacy of brimonidine Purite 0.15% (Alphagan P 0.15%; Allergan, Inc., Irvine, Calif) given as adjunctive therapy with latanoprost 0.005% (Xalatan; Pfizer Inc., New York, NY( to patients with open-angle glaucoma or ocular hypertension. In this multicenter, open-label, prospective evaluation, the intraocular pressure (IOP) of the 43 enrolled patients was > or =18 mm Hg after at least 6 wk of latanoprost monotherapy. The primary outcome measure was IOP at peak drug effect )10 AM, or approximately 2 h after the morning dose of brimonidine 0.15%(. IOP at trough drug effect (8 AM, or approximately 12 h after the evening dose of brimonidine) was also measured. Baseline IOP was 21.9 (+/-2.3) mm Hg. After 1 mo of treatment, additional mean IOP reductions from latanoprost-treated baseline values were 5.8 mm Hg (26%) at peak drug effect (P<.001) and 3.3 mm Hg (15%) at trough (P<.001). At the month 2 visit, additional mean IOP reductions from latanoprost-treated baseline values were 5.1 mm Hg (23%) at peak drug effect (P<.001) and 2.0 mm Hg (9%) at trough (P=.002). Brimonidine Purite 0.15% provided statistically significant additional reductions in IOP from latanoprost-treated baseline values. These findings suggest that brimonidine Purite 0.15% is an efficacious adjunctive therapy in patients given latanoprost who require additional lowering of IOP.  相似文献   

12.
OBJECTIVE: The purpose of this study was to indirectly quantify and compare the intraocular pressure (IOP)-lowering effects of latanoprost and brimonidine eye drops at baseline and after 3 and 6 months in the treatment of primary open-angle glaucoma. METHODS: This meta-analysis combined data from all randomized controlled trials comparing the effects on IOP of latanoprost and brimonidine treatment in adults with a baseline IOP > or =20 mm Hg. MEDLINE and EMBASE were searched for reports of the ophthalmic administration of either drug versus the other, placebo, or active therapy. Included studies reported IOP as either means or differences (with SD or SE) and sample sizes. A random-effects model was used to pool data within each drug group. As a proxy for success rates, area under the curve (AUC) was calculated for the proportion of patients having an IOP <20 mm Hg. RESULTS: One hundred fifty-five articles reporting on 158 trials were identified; 147 papers were rejected (141 were not randomized controlled trials, 5 were duplicates, and 1 had nonextractable data), leaving 9 trials from 8 articles. A total of 2152 patients were included in the meta-analysis: 597 received latanoprost, 571 received brimonidine, and the remainder received timolol or betaxolol. Baseline IOPs were similar in patients randomized to latanoprost or brimonidine (25.3 and 24.6 mm Hg, respectively). At 3 months, latanoprost and brimonidine reduced IOP by 8.4 and 6.5 mm Hg, respectively (P = 0.004 latanoprost vs brimonidine), and at 6 months by 8.0 and 6.2 mm Hg, respectively (P = 0.045). AUC was 0.834 and 0.675 at 3 months for latanoprost and brimonidine, respectively, and 0.817 and 0.715 at 6 months, respectively (both, P < 0.001). CONCLUSIONS: This indirect comparison of data from the available randomized clinical trials showed latanoprost to be statistically superior to brimonidine in reducing IOP in adults with primary open-angle glaucoma. Additional long-term, head-to-head comparisons of the efficacy, safety, and cost of latanoprost and brimonidine are needed to support and supplement these findings.  相似文献   

13.
BACKGROUND: The alpha-adrenergic agonist brimonidine and the carbonic anhydrase inhibitor dorzolamide have been studied both as monotherapy and in combination with beta-blockers in the treatment of glaucoma and ocular hypertension; however, a MEDLINE literature search failed to reveal any clinical studies directly comparing these 2 agents as adjunctive therapy. OBJECTIVE: The purpose of this study was to compare the intraocular pressure (IOP)-lowering efficacy of brimonidine and dorzolamide as adjunctive therapy to beta-blockers in adult patients with glaucoma or ocular hypertension. METHODS: In a prospective, investigator-masked, multicenter, parallel-design clinical trial, adult patients whose IOP was inadequately controlled with topical beta-blocker therapy were randomly assigned to receive brimonidine 0.2% twice daily or dorzolamide 2% 3 times daily as adjunctive therapy for 3 months. Efficacy was determined by the reduction in IOP from baseline. After 1 month of adjunctive treatment, patients who failed to meet a target 15% reduction in IOP at peak drug effect were crossed over to the other study medication. RESULTS: A total of 106 patients were treated. Approximately 70% (74/106) of the patients were white, and 61.3% (65/106) had a diagnosis of open-angle glaucoma. Mean baseline IOP (ie, with beta-blocker monotherapy) was comparable between treatment groups (approximately 21 mm Hg). After 1 month of adjunctive treatment, the mean daily IOP reduction was significantly greater with brimonidine (4.40 mm Hg, 20.4%) than with dorzolamide (3.0 mm Hg, 14.4%, P = 0.033). At peak drug effect at month 1, the mean IOP reduction was significantly greater in the brimonidine group (5.95 mm Hg, 27.6%) than in the dorzolamide group (4.11 mm Hg, 19.7%; P = 0.007). Significantly more patients treated with brimonidine (44/51, 86.3%) than with dorzolamide (29/47, 61.7%) achieved the target 15% reduction in IOP at month 1 (P = 0.005). At month 3, the mean daily IOP reduction and the mean IOP reduction at peak drug effect were not significantly different in the 2 treatment groups. The mean daily IOP reduction was 4.98 mm Hg in the brimonidine group and 3.15 mm Hg in the dorzolamide group (P = 0.092). At peak drug effect, the mean IOP reduction was 6.39 mm Hg with brimonidine and 4.06 mm Hg with dorzolamide. The incidence of adverse events leading to discontinuation was 9.3% (5/54) in the brimonidine group (depression, 2; allergic conjunctivitis, 1; dry mouth and tearing, 1; dermatitis, 1) and 9.8% (5/51) in the dorzolamide group (ocular burning and stinging, 2; ocular itch, 1; gastrointestinal complaints, 1; lack of tolerance for beta-blocker, 1), with no significant difference between groups. CONCLUSION: In this trial, brimonidine 0.2% twice daily produced greater mean decreases in IOP and was effective in more patients than dorzolamide 2% 3 times daily when used as adjunctive therapy to beta-blockers.  相似文献   

14.
目的观察青光眼滤过术后硬核性白内障改良手术方式的临床效果。方法对青光眼小梁切除术后半年以上的硬核性白内障患者共82例(114眼)行颞侧角膜缘反眉弓板层巩膜隧道切口,开罐式破囊,水分离,用注水晶状体圈匙缓慢娩出晶体核,对有虹膜后粘连者进行分离,对瞳孔变形和散大者用0/10线进行瞳孔缝合成形。术中不做直肌牵引缝线和烧灼止血,避开滤过泡,整个手术过程均在密闭状态下完成。术后随访6~12个月,观察术后视力、眼压、滤过泡和并发症等。结果①110眼术后视力均有不同程度的提高,视力≥0.6者34眼(占29.82%);0.4~0.6者47眼(占41.23%);0.2.0.4者27眼(占23.68%);≤0.2者6眼(占5.26%);②术眼滤过泡保存完好,未出现滤过泡破损及粘连等情况;③术后瞳孔成形效果好,41眼的瞳孔上移、散大和变形得到改善;④术后眼压保持稳定,所有患者眼压均在8~20mmHg(平均为15.15±2.78mmHg)范围内,与术前眼压(平均15.23±2.87mmHg)比较,差异无统计学意义(t=0.21,P〉0.05);⑤术后有38眼出现不同程度的角膜水肿,3眼出现较为严重的葡萄膜炎性反应,经治疗后均逐渐消退。结论采用本法改良的术式对青光眼滤过术后硬核性白内障施行摘除手术的疗效较好且操作简单、便于推广。  相似文献   

15.
OBJECTIVE: This study compared brimonidine with latanoprost as adjunctive therapy for the treatment of open-angle glaucoma and ocular hypertension. BACKGROUND: Patients with open-angle glaucoma or ocular hypertension often require >1 medication to achieve control of intraocular pressure (IOP). Both brimonidine and latanoprost effectively lower IOP, but no previously reported clinical trials have directly compared these agents as adjunctive therapy. METHODS: This was a prospective, randomized, investigator-masked, multicenter, parallel-design clinical trial. Forty patients (69 study eyes) with uncontrolled IOP of < or =34 mm Hg while using a topical beta-blocker plus dorzolamide or pilocarpine were randomly assigned to receive either brimonidine 0.2% BID or latanoprost 0.005% QD over 6 months as adjunctive therapy. Tolerability was assessed by reports of adverse events, and efficacy was determined by reduction in IOP from baseline. Clinical success was defined as the achievement of a > or =15% reduction in IOP from baseline. RESULTS: There were no significant between-group differences in any demographic variable. Most patients in each group were white, had open-angle glaucoma, and were being treated with a nonselective beta-blocker and dorzolamide. When brimonidine or latanoprost was used as an adjunctive agent with a beta-blocker and dorzolamide or pilocarpine, the rates of clinical success at month 1 were 85% (17/20 patients) with brimonidine versus 65% (13/20 patients) with latanoprost (P = 0.144). Overall mean IOP reduction at month 1 was 4.60+/-0.62 mm Hg (22.8%; P < 0.001) with brimonidine and 3.43+/-0.62 mm Hg (17.2%; P < 0.001) with latanoprost, with no significant differences between groups (P = 0.219). Among the patients with an inadequate IOP-lowering response (<15% reduction from baseline), the mean IOP reduction was 0.36+/-0.66 mm Hg with latanoprost (n = 7) and 0.50+/-2.18 mm Hg with brimonidine (n = 3). Brimonidine and latanoprost had comparable IOP-lowering efficacy in patients receiving concomitant pilocarpine therapy (mean change in IOP of -4.23 mm Hg vs -3.75 mm Hg, P = 0.173). In patients concurrently treated with dorzolamide, brimonidine produced a mean change in IOP of -5.29 mm Hg, compared with a mean change of -3.21 mm Hg in the latanoprost group (P = 0.159). Both brimonidine and latanoprost were well tolerated. Few adverse events leading to discontinuation were observed with either drug regimen (n = 2 with brimonidine; n = 0 with latanoprost). CONCLUSIONS: Both brimonidine 0.2% BID and latanoprost 0.005% QD were well-tolerated and reduced IOP in most patients when used as third-line adjunctive therapy. However, clinical success was achieved by 17 of 20 patients (85%) who received brimonidine, compared with 13 of 20 patients (65%) who received latanoprost (P = 0.144). These results suggest that brimonidine 0.2% BID may be more reliable than latanoprost 0.005% QD as adjunctive therapy for glaucoma and ocular hypertension.  相似文献   

16.
目的观察超声乳化联合小梁切除术,术中应用丝裂霉素(MMC)及经角膜的调整缝线治疗青光眼合并白内障的临床效果。方法69例(72眼)术中做以角膜缘为基底的结膜瓣,再以角膜缘为基底做5mm×4mm 1/2板层厚巩膜瓣,0.2—0.4mg/ml MMC棉片置于结膜和巩膜瓣下3—5min,再以大量BSS冲洗,继之进行超声乳化及人工晶体植入术,切除小梁2mm×2.5mm,剪除周边虹膜少许。巩膜瓣顶端间断缝合2针,侧面缝经角膜的调整缝线。间断缝合Tenon’s囊,结膜连续缝合。结果平均随访(7.36±4.64)个月,术后视力提高者46眼(63.89%),不变19眼(26.39%),下降7眼(9.27%)。术前平均眼压(28.67±10.69)/mm Hg(1mm Hg=0.133KPa)。术后随访期末眼压21mmHg以下66眼(91.67%),功能性滤过泡91.67%,非功能滤过泡6眼(8.33%)。并发症包括角膜水肿,浅前房、前房渗出等。结论超声乳化联合小梁切除及术中应用丝裂霉素、调整缝线是治疗青光眼合并白内障的有效方法。  相似文献   

17.
BACKGROUND: Prostaglandin analogues are effective ocular hypotensive agents and are being used increasingly in the treatment of elevated intraocular pressure (IOP). These agents are typically dosed once daily. OBJECTIVES: A pilot study was conducted to evaluate the duration of travoprost's IOP-lowering efficacy up to 84 hours after the final dose in patients with open-angle glaucoma. A follow-up study was conducted to compare diurnal IOP control with travoprost and latanoprost over a 44-hour period. METHODS: In the open label pilot study, patients received 0.004% travoprost in both eyes at 8 pm daily for 2 weeks. After 2 weeks, IOP was measured before administration of the last daily dose, every 4 hours thereafter for 36 hours, and 60 and 84 hours after the last dose, with no additional ocular hypotensive medication given. In the controlled, double-masked, parallel-group, follow-up study, patients were randomized to self-administer 1 drop of the marketed doses of 0.004% travoprost or 0.005% latanoprost in both eyes at 8 pm daily for 2 weeks. At the end of this period, patients returned to the facility at approximately 8 pm for IOP measurement and administration of the final dose of study medication. IOP was then measured at 4-hour intervals for 44 hours after the last dose, with no additional ocular hypotensive medication given. RESULTS: The pilot study included 21 patients (67% female, 33% male; age range, 35-81 years) with open-angle glaucoma. IOP values were significantly below baseline at all time points up to 84 hours after the final dose of travoprost ( P<0.001). The follow-up study enrolled 35 patients, 1 of whom was excluded for missing data; thus, the intent-to-treat analysis included 34 patients (68% female, 32% male; age range, 36-72 years). At the unmedicated eligibility visit, mean IOP over 24 hours ranged from 21 to 26 mm Hg in each treatment group. After 2 weeks of treatment and 24 hours after the last dose, mean (SD) IOP was 13.1 (2.1) mm Hg (change from eligibility visit, -10.4 [2.7] mm Hg) in the travoprost group and 16.0 (3.1) mm Hg (change from eligibility visit, -7.1 [2.4] mm Hg) in the latanoprost group. The difference in change from baseline was statistically significant between treatment groups (P=0.006). Travoprost lowered IOP significantly at all time points throughout the 44-hour period after the last dose (mean IOP, 相似文献   

18.
This study was undertaken to evaluate the efficiency of a trabecular micro-bypass stent designed to allow direct aqueous drainage from the anterior chamber into Schlemm’s canal in patients with glaucoma. In this prospective case series of 6 patients with open-angle glaucoma, the microstent was inserted ab interno under local anesthesia in an ophthalmic operating room. Patients were seen postoperatively at 1 to 2 d, 1 wk, and 1, 2, 6, and 12 mo. All stents were successfully placed within Schlemm’s canal. Mean intraocular pressure (IOP) at preoperative baseline was 20.2±6.3 mm Hg (range, 14–31 mm Hg). Mean IOP decreased during the immediate postoperative period to approximately 12 to 13 mm Hg and was stabilized at 14 to 15 mm Hg with reduction of medication throughout 1 y of follow-up. No major complications occurred. According to observations reported in this feasibility study, the microstent was effective in reducing IOP and in decreasing the number of glaucoma medications required to control IOP. Implantation procedures were safe, and stents remained in place throughout the follow-up period. None of the complications traditionally associated with filtering surgery were reported. Further research on this stent in a larger group of patients is needed to assess its role in glaucoma therapy.  相似文献   

19.
In an open-label 12-week study, the safety and efficacy of bimatoprost 0.03% was evaluated in 55 patients with open-angle glaucoma or ocular hypertension inadequately controlled by topical beta-blocker monotherapy. Patients discontinued their topical beta-blocker therapy at the baseline visit and began bimatoprost monotherapy that evening. Study visits were at 6 and 12 weeks postbaseline. Bimatoprost reduced intraocular pressure (IOP) 4.5 mm Hg (21.5%; P< .001) from baseline at week 6 and 4.2 mm Hg (19.6%; P< .001) at week 12. Patients were more likely to achieve low target pressures with bimatoprost than with topical beta-blockers. Conjunctival hyperemia was the most commonly reported adverse event. The findings from this study indicate bimatoprost monotherapy provides a substantially greater IOP reduction than topical beta-blocker therapy and allows more patients to achieve a low target pressure. Bimatoprost is an effective alternative to topical beta-blockers for the treatment of glaucoma and ocular hypertension.  相似文献   

20.
目的了解青光眼小梁切除术后眼脉动振幅的变化。方法2008年3月-2009年6月确诊的青光眼患者32例,使用瑞士(MicrotechnologyAG公司)动态轮廓眼压计测量小梁切除术前后眼压及眼脉动振幅(OPA)的变化,进行统计分析。结果术前、术后眼压分别为(19.41±5.06)、(11.86±3.52)mmHg(P〈0.05);术前、术后OPA分别为(3.92±1.76)、(2.04±1.38)mmHg(P〈0.05)。术前眼压与OPA、术后眼压与OPA均有相关性。结论青光眼小梁切除术后OPA会随眼压变化出现相应的变化,在青光眼的诊断及治疗中有一定的意义。  相似文献   

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