青光眼滤过术后合并睫状体脉络膜脱离的恶性青光眼

目的探讨青光眼滤过术后合并睫状体脉络膜脱离的恶性青光眼的发病机制、临床特点及预防。方法对4例（4只眼）青光眼滤过术后合并睫状体脉络膜脱离的恶性青光眼患者的临床资料进行回顾性分析。结果 4例（4只眼）在术后早期即出现Ⅱ°、Ⅲ°浅前房,通过眼底检查、手术及超声生物显微镜（UBM）检查发现睫状体脉络膜脱离、睫状环阻滞,经睫状体脉络膜上腔放液,并根据病情联合玻璃体水囊抽吸、前段玻璃体切除以及晶状体手术等,所有患眼眼压均恢复正常,前房加深,脉络膜脱离消失。结论睫状体脉络膜脱离是发生恶性青光眼的诱发因素,预防睫状体脉络膜脱离是预防恶性青光眼发生的关键;对术后早期即出现的Ⅱ°、Ⅲ°浅前房,及时进行UBM检查有助于明确诊断,可减少治疗的盲目性。

Glaucoma filtering surgery accompanying choroidal detachment of malignant glaucoma

Objective Of glaucoma filtration surgery accompanying choroidal detachment of malignant glaucoma pathogenesis,clinical features and prevention.Methods 4 cases of 4 glaucoma filtering surgery accompanying choroidal detachment of malignant glaucoma patients retrospectively the clinical data and analysis.Results 4 eyes of 4 cases that occurred in the early postoperative Ⅱ °and Ⅲ ° shallow anterior chamber,through the fundus examination,surgical and UBM examination showed choroidal detachment,ciliary block,released by the ciliary choroidal fluid,and the condition of patients vitrectomy cystic aspiration,anterior vitrectomy,and lens surgery,all patients returned to normal intraocular pressure,anterior chamber deepened,choroidal detachment disappeared.Conclusion Choroidal detachment is a predisposing factor in malignant glaucoma,choroidal detachment prevention is the key to prevention of occurrence of malignant glaucoma;on early that appears Ⅱ °and Ⅲ ° shallow anterior chamber,in a timely manner will help UBM examination to confirm the diagnosis,treatment can reduce blindness.