色素性青光眼的临床特征及处理

目的 观察色素性青光眼的临床表现及特征,探讨其治疗方法及预后.方法 色素性青光眼患者8例16只眼,均为男性.年龄19～48岁(34.13±7.12)岁.观察眼压、裂隙灯显微镜、房角、超声生物显微镜(UBM)、眼底及视野等;9只眼行小梁切除术,7只眼行Nd:YAG激光周边虹膜切除.随访时间为12～36个月.结果 所有病例都为近视,1例为高度近视;眼前段色素播散表现为:75%(6例12只眼)的患眼有典型的Krukenberg梭.所有患眼晶状体韧带后囊附止部及晶状体韧带小束均可见色素沉着;周边虹膜后凹;小梁网上均可见宽、均匀而较致密的色素带(Ⅲ级);超声生物显微镜检查示所有患者均存在反向瞳孔阻滞现象,6例存在虹膜一睫状突接触.术后3月复查UBM显示所有患者周边虹膜形态平坦,反向瞳孔阻滞现象解除.所有患者眼压均控制平稳.为10.5～19mmHg(14.3±5.2)mmHg.Humphrey视野检查显示无进展情况.结论 色素性青光眼为一表现相对复杂的特殊类型的青光眼,需要正确认识并适时给予恰当的治疗.

Clinical characteristics of pigmentaryglaucoma in Chinese patients.

Objective To observe the clinical manifestations,signs and prognosis of pigmentary glaucoma(po).Methods Eight patients with PG of 16 eyes(all were men)were studied,the range of age iS 19 to 48 years(mean±sd 34.13±7.12),IOP,KP,anterior chamber,iris,optic nerve disc and visual field were observed.Of 9 eyes were performed with trabeculectomy,7 eyes were done with laser iridolectomy,follower up over 12 to 36 months.Results All had myopia of -0.5 D or greater,one was high myopia.All patients showed homogenous increased TM pigmentation,lenticular and/or zonular pigmentation,as well as posterior iris bowing.75% of patients had Krukenberg spindle.None of the patients exhibited spoke-like mid-peripheral iris transillumination defects(ITDs).All had reverse pupilary block,among them 6 patients had iris-ciliary body process contact.Throe months postoperatively,peripheral iris became fiat,reverse pupilary block was deleted.The average IOP was 14.3+/-5.25mmHg(ranged 10.5-19mmHg).Conclusions The most common clinical findings in Chinese PG patients include homogcneons TM pigmentation and pigment granule dusting on lens zonules and/or posterior peripheral lens surface.ITDs are uncommon in Chinese patients with PG.It should be treated appropriately