闭角型青光眼行复合式小梁切除术后早期高眼压的原因分析

目的：分析闭角型青光眼患者行复合式小梁切除术后1mo内发生高眼压(>21mmHg)的原因及处理方法。

方法：回顾性研究我院2010-03/2013-03应用复合式小梁切除术治疗闭角型青光眼术后1mo内高眼压的病例34例38眼，分析其原因，总结处理方法。

结果：导致术后早期高眼压的因素有：恶性青光眼8例9眼，巩膜瓣下血凝块及结缔组织阻塞13例15眼，术后前房积血5例5眼，巩膜瓣内切口被虹膜组织嵌顿3例3眼，术前高眼压持续时间长4例5眼，原因不明1例1眼。经对症治疗后，患者眼压均控制在21mmHg以下。

结论：闭角型青光眼行复合式小梁切除术后早期高眼压是由多因素造成的，早期预防、及时处理是手术成功的关键。

Causes analysis of early postoperative high intraocular pressure of angle-closure glaucoma underwent compound trabeculectomy

AIM:To analyze the causes and treatments of high intraocular pressure(>21mmHg)of angle-closure glaucoma underwent compound trabeculectomy 1mo after surgery.

METHODS:This was a retrospective study of our hospital, from March 2010 to March 2013. Thirty-four(38 eyes)of angle-closure glaucoma patients were collected, who underwent compound trabeculectomy with high intraocular pressure(>21mmHg)1mo after operation. We analyzed the causes and summarized the treatments.

RESULTS:The causes which lead to early postoperative high intraocular pressure included malignant glaucoma(9 eyes of 8 cases), blood clot and connective tissue block under the scleral flap(15 eyes of 13 cases), hyphema after surgery(5 eyes of 5 cases), sclera flap incision was incarcerated with iris tissue(3 eyes of 3 cases), preoperative high intraocular pressure for a long time(5 eyes of 4 cases), 1 eye of 1 case for unknown reason. After proper treatments, intraocular pressures of all patients were bellowed 21mmHg.

CONCLUSION:Early postoperative high intraocular pressure of angle-closure glaucoma underwent compound trabeculectomy is caused by various factors, and the early prevention and timely treatment are key points of a successful operation.