晶状体玻璃体切除联合小梁切除术治疗晶状体脱位继发性青光眼的疗效观察

目的 评价晶体玻璃体切除术联合小梁切除治疗晶状体脱位继发性青光眼的疗效.方法 回顾性分析20例(20只眼)外伤性晶体脱位合并继发性青光眼资料,手术方法采用标准玻璃体切割三通道切口,上方小梁切除,术中巩膜瓣下使用0.1%丝裂霉素C(mitomycin C,MMC),对术前、术后视力、眼压及并发症等情况进行分析.结果 视力提高18只眼(90%).术后以不用或需要用局部降眼压药,6mmHg≤眼压≤21mmHg为成功标准,15只眼成功(占75%).5只眼不成功,其中4只眼＞21mmHg(占20%),1只眼眼压＜6mmHg(占5%).20只眼中15只眼(75%)形成滤过泡,5只眼无明显滤过泡.术后眼内出血4只眼,低眼压8只眼,其中脉络膜脱离4只眼,滤过过强2只眼,滤过泡漏1只限,术后长期低眼压1只眼.结论 晶体玻璃体切割联合小梁切除治疗晶状体脱位继发性青光眼可以降低眼压,提高视力,是一种安全有效的方法.

Ientectomy and vitrectomy combined with filtering operation and mitomycin C for complex traumatic glaucoma

Objective Evaluate the clinical effect of lentectomy and vitroctomy combined with filtering operation and mitomycin C for complex traumatic glancoma.Methods The data in 20 cases 20 eyes of traumatic lens dislocation combining with secondarg glaucoma were analysed retrospectively.The operation of lentectomy and itrectomy combined with filtering operation and mitomycin C was performed.Prenperation and postoperation visual acuity,intraocular tension and complications were observed.ResultsThe visual acuity of 18 eyes (90%)were improved.The successful criteria was 6mmHg ≤IOP ≤ 21mmHg with or without local IOP-Iowering medications.15 of 20 eyes were successful (75%),5 eyes unsuccessful (20%),in which the IOP of 4 eyes was above 21 mmHg(20%),one eye bellow 6 mmHg(5%).The filtering bleb was formed in 15 eyes (75%)and not formed in the other 5 eyes.The intraocular hemorrhage was observed in 4 eyes.The intraocular hypotension was detected in 8 eyes,in which choroidal detachment was 4 eyes,excessive filtration 2 eyes,the leakage of filtering bleb in one eye.Conclusion Lentectomy and vitrectomy combined with filtering operation and mitomycin C is relatively safe and effective to treat complex traumatic glaucoma caused by lens dislocation,which can lower IOP and improve vision acuity.