玻璃体疝的治疗及临床观察

目的临床观察前房玻璃体疝的治疗,探讨其并发症及最佳处理方式。方法玻璃体疝7例（8眼）。其中5眼根据不同情况选用前房穿刺,YAG周边虹膜切除术,晶状体摘出、切除或超声乳化,玻璃体切除或Ahmed青光眼阀治疗;1眼用药物治疗;另2眼的眼压正常未作治疗。结果随访6～15个月。6眼玻璃体疝经保守治疗或前房穿刺术后行YAG周边虹膜切除术,眼压控制良好,角膜水肿0级,视力不变或提高;1眼行白内障摘出、玻璃体疝剪除后,眼压失控行前段玻璃体切除联合青光眼阀门植入术;1眼行玻璃体切除联合晶状体切除,再加药物治疗后,眼压正常,角膜水肿0级,视力提高。结论玻璃体疝无症状者不需处理;激发角膜水肿、眼压升高者可行前房穿刺术联合YAG周边虹膜切除术,前房玻璃体平静,可不予处理;伴有晶状体脱位者采取晶状体切除联合玻璃体切除术治疗,力争用最小、最少的手术方式来处理玻璃体疝及其并发症。

The treatment and observation ol vitreous hernia

Objective To observe the treatment and efficacy of vitreous hernia. Complications and best treatments were ob-served. Methods 3 cases（3 eyes） of vitreous hernia without com- plications were not treated. 2 cases（2 eyes） of vitreous hernia were applied paracentesis of anterior chamber. 1 case（ 1 eye） and 1 case （1 eye was treated earlier） applied wi i： h YAG Laser in peripheral iridectomy after applied paracentesis of anterior chamber. 1 case（1 eye was treated late） of vitreous hernia were applied phaco ＋ anterior vitrectomy ＋ AGV. 1 case（1 eye） of vitreous hernia were applied vitrectomy ＋ cataract extraction ＋ drug. The visual acuity, itraocular pressure and corneal edema were observed. Results In follow-up 6-15 months. 5 cases（6 eyes） without surgery,the ocular pressure dropped to 21 mmHg below,the visual acuity increased or maintained,the grate of corneal edema was 0; 1 case（1 eye） was treated with phaco ＋ cuting vitreous hernia,the ocular pressure were not contro! ed. 1 case（1 eye） has normal ocular pressure,the grate of corneal edema was 0,the visual acuity increased after vitrectomy ＋ cataract extraction ＋ drug. Conclusions Vitreous hernia were not treated without complications; Vitreous hernia with corneal edema and high ocular pressure were applied YAG Laser in peripheral iridectomy after paracentesis of anterior chamber. Vitreous hernia with luxation of the lens were applied vitrectomy ＋ cataract extraction. It is needed with small and least surgery to heat vitreous hernia and complications.