前段玻璃体切除术的临床应用探讨

目的探讨前段玻璃体切除术的临床应用及疗效。方法分析自2003年3月至2008年12月124例（124眼）因病情需要进行前段玻璃体切除手术,随访3个月至4年,总结疗效经验。结果眼外伤二期重建眼前段28例（22.58%）,外伤性白内障（晶状体穿孔伤）继发青光眼22例（17.74%）,晶状体源性青光眼（包括晶状体溶解性青光眼及晶状体膨胀性青光眼）27例（21.77%）,顽固性炎症引起瞳孔闭锁、并发性白内障、继发性青光眼10例（8.07%）,睫状环阻塞性青光眼12例（9.68%）,小儿白内障（5-12岁）行后囊环形撕囊结合前段玻璃体切除14例（11.29%）,白内障摘出术中处理后囊破裂玻璃体溢出11例（8.87%）。经随访发现,术后除2例难治性青光眼再次行睫状体光凝后眼压控制,及1例瞳孔膜闭术后2d前房积血,治疗后积血吸收,其余均达到术前预期效果。结论前段玻璃体切除能有效治疗多种原因引起的眼压升高、角膜水肿等不良并发症。

Clinical use of anterior vitrectomy

Objective To investigate the clinical use of anterior vitrectomy. Methods Anterior vitrectomy was performed on 124 patients（124 eyes）,to evaluate the surgical effectiveness.Followed up for 3months to 4 years. Results History：1）related with ocular trauma： secondary reconstruction of anterior segment in ocular trauma in 28 cases（22.6%）,traumatic cataract（penetrating cataract） with secondary glaucoma in 22 cases（17.7%）.2） phacolytic glaucoma in 27 cases（21.8%）,3） seclusion of pupil、 complicated cataract,secondary glaucoma caused by hard uveitis in 10 cases（8.1%）,4） malignant glaucoma in 12 cases（9.7%）,5） cataract children（5 to 12 years old）with PCCC＋AV or ACCC＋AV in 14 cases（11.3%）.6）dealed with posterior capsular broken in cataract operations in 11 cases（8.9%）.In the observation group,all cases reached the expected effects,except 2 cases of malignant glaucoma,whose IOP were controlled after cyclophotocoagulation,1 case of seclusion of pupil with hyphema two days later,whose blood absorbed after drug treatment. ConclusionAnterior vitrectomy is an effective procedure in treating complications such as ocular hypertension,corneal hydrops.It was also widely used in kinds of secondary reconstruction of anterior segment in ocular trauma and cataract in children.It creates more conditions for secondary operations.