青光眼滤过术后浅前房的前房重建手术

目的探讨青光眼滤过术后浅前房的前房重建手术时机及手术方法。方法34例（36眼）浅前房（包括无前房）者中23眼行脉络膜上腔放液联合前房注气；8眼行玻璃体水囊抽液联合前房注气；2眼行玻璃体水囊抽液联合白内障囊外摘出及后房型人工晶状体植入；3眼行前房角分离、前房形成、小梁切除联合囊外摘出或人工晶状体植入。结果36眼中33眼在浅前房发生2周内手术，2月、4月、9月手术各1眼。其中30眼一次手术成功；3眼脉络膜上腔放液联合前房注气者经原角膜穿刺口进行了二次注气成功；2眼行玻璃体水囊抽液联合前房注气后前房仍不能形成改行其它手术方式成功；1眼前房角分离、前房形成、小粱切除联合囊外摘出术者手术失败。结论青光眼滤过术后Ⅱ度浅前房保守治疗最长不要超过2周，无效时须考虑前房重建手术；Ⅲ度浅前房一旦发生应立即手术。根据浅前房原凶要选择不同的手术或进行多手术联合。

Reconstruction of shallow anterior chamber after glaucoma filtering surgery

Objective To explore the operative opportunity and method of shallow anterior chamber including the absent one after glaucoma filtering surgery.Methods Among 34 cases(36 eyes)of shallow anterior chambers,23 eyes were performed to drain out suprechoroidal fluid and inject air into anterior chamber;8 eyes were done to draw out aqueous in vitreous pool combining with injecting air into anterior chamber;2 eyes were done to draw out aqueous in vitreous pool combining with extracapsular cataract extraction as well as implantation of posterior chamber intraocular lens;3 eyes were done to be given goniosynechialysis combining with trabeculectomy and combining with extracapsular cataract extraction or implantation of posterior chamber intraocular lens. Results Among 36 eyes,33 eyes were given operation in shallow anterior chamber within two weeks with each eye operated at 2,4,9 months respectively.30 ones were operatively successful for the first time,3 ones with suprechoroidal fluid drained out and air injected were injected air for the second time via primary corneal paracentesis point;2 ones with aqueous in vitreous pool drawed out combining with anterior chamber injected air into,in view of still failing to form anterior chamber,were performed other operative mode successfully instead;1 eye that was given goniosynechialysis combining with trabeculectomy and combining with extracapsular cataract extraction was of operative failure. Conclusions When reserved treatment of degree II shallow chamber has been given and has reached the longest time of two weeks after glaucoma filtering surgery but still is ineffective,it is imperative that anterior chamber reconstructive operation come into consideration and operation be given at once as soon as degree III shallow chamber occurred.A variety of operative modes should be selected or multiply operative combination be performed according to the causes of shallow anterior chambers.