眼后段疾病相关青光眼的临床分析

目的：探讨与眼后段疾病相关的青光眼的病因及相应治疗措施。方法：对74例与眼后段疾病相关的青光眼患者的临床资料行回顾性分析。结果：74例患者中硅油继发青光眼39例，经手术及药物治疗，眼压可控制正常。新生血管性青光眼(Neovascular glaucoma,NVG)29例，多数行视网膜周边冷冻联合视网膜光凝等抗增殖手术，治愈率为15％，有效率为60％。6例行玻璃体切割、内眼激光、周边视网膜冷冻(或联合硅油填充)术，3例术后眼压正常，5例新生血管消退。外伤性晶体脱位、玻璃体嵌顿、视网膜脱离继发青光眼4例，因眼后段疾患行多次手术引起瞳孔闭锁继发青光眼2例，手术治疗后眼压正常。结论：硅油继发青光眼、外伤性品体脱位、玻璃体嵌顿继发青光眼、瞳孔闭锁继发青光眼等经药物及手术治疗眼压可控制正常，预后较好，而NVG仍是治疗的难题，抗增殖手术如玻璃体切割、内眼激光、周边视网膜冷冻联合硅油填充术可能会成为治疗NVG的一种有效手段，但需进一步探讨。

Clinical characteristics of secondary glaucoma associated with posterior segment disease

Objective:To discuss the etiology and the management of secondary glaucoma associated with posterior segment diseases. Methods:The clinical data of 74 cases were analyzed retrospectively. Results:39 of the 74 cases were the patients with glaucoma induced by silicone oil whose intraocular pressure (IOP) could be controlled with medical and/or surgical therapies.29 of the 74 cases were patients with neovascular glaucoma.And the majority of them underwent the peripheral retina cryo-coagulation by which the IOP was controlled in 15% of the cases (3/20) and was lowered than that before in 60% of the cases (12/20).6 of 29 neovascular glaucoma cases underwent antiproliferative surgical procedures including vitrectomy,panretinal laser treatment and cryo-coagulation of peripheral retina or followed by silicone oil tamponade,the IOP was controlled in 3 cases,new vessels disappeared in 5 cases.4 of the 74 cases were resulted from traumatic retinal detachment combined with dislocation of lens and vitreous,and the last 2 were resulted from pupillary block,in which the IOP could be controlled with surgical treatment. Conclusions:Neovascular glaucoma is hard to cure,antiproliferative surgery may play a valuable role.IOP in other secondary glaucoma associated with posterior segment diseases can be controlled with medical and/or surgical management.