恶性青光眼18例综合治疗的临床分析

目的:探讨恶性青光眼综合治疗方法的治疗效果。方法:对12例14眼小梁切除术后的恶性青光眼,6例6眼白内障囊外摘除+人工晶状体植入术后的恶性青光眼进行药物及玻璃体腔水囊抽吸术治疗。结果:白内障囊外摘除+人工晶状体植入术后的4例4眼恶性青光眼患者在术中发现并及时行玻璃体腔水囊抽吸联合前房形成术;其余14例16眼先用药物治疗2d无效后,行玻璃体腔水囊抽吸术1～2次,其中1例1眼(小梁切除术后)在行2次玻璃体腔水囊抽吸术后未能控制眼压、恢复前房,经行白内障囊外摘除+人工晶状体植入+玻璃体水囊抽吸术,全部成功。眼压控制理想,前房正常,随访平均21mo期间未复发。结论:恶性青光眼治疗中,抽吸玻璃体腔水囊、解除睫状环阻滞、建立前房是成功的关键。

Clinical analysis on 18 cases in treating malignant glaucoma

AIM:To discuss the effect of synthesis methods in treating malignant glaucoma.METHODS: We treated malignant glaucoma, performed trabeculectomy on 12 cases (14 eyes) and extracapsular cataract extraction (ECCE) combined with intraocular lens implantation (IOL) on 6 cases (6 eyes), with the avulsion of hydrocele in vitreous and the medicine.RESULTS: Four cases (4 eyes) of malignant glaucoma after ECCE combined with IOL were treated with the avulsion of hydrocele in vitreous associated with anterior chamber forming; 14 cases (16 eyes) of malignant glaucoma having no effect after 2 days medication, were treated with the avulsion of hydrocele in vitreous once or twice, thereinto, 1 case was treated with ECCE combined with IOL and the avulsion of hydrocele in vitreous. All cases performed successfully during the follow-up (21 months).CONCLUSION: In the treatment of malignant glaucoma, the keys of success are the avulsion of hydrocele in vitreous, freeing from the ciliary block, and forming the anterior chamber.