43例原发性急性闭角型青光眼的临床分析

目的分析研究急性闭角型青光眼的自然病程、危险因素、诊断处理及临床效果。方法回顾43例原发性闭角型青光眼住院患者的临床资料,分析研究急性闭角型青光眼的发病情况、诱因、治疗方案及治疗效果。结果本组43例,45眼。其中男性11例,女性32例。年龄42-80岁。明确家族史者3例,诱因为劳累或休息不好者5例,情绪激动3例,散瞳2例,其他手术后2例。给予单纯药物治疗7例(15.56%),手术治疗36例(83.72%)。药物治疗后3例患者视力无明显提高(7.0%),其余均较发作时视力明显提高(93%),药物治疗组中2例视力提高且眼压正常,余5例均有视力不提高,或眼压高,或瞳孔扩大。治疗组中虹膜萎缩、瞳孔固定11例(25.6%)。结论原发性闭角型青光眼好发于中老年女性,劳累、情绪因素、散瞳等可诱发急性闭角型青光眼发作,其对视功能影响很大,治疗的关键在于早期诊断、及时治疗。

Clinical analysis of primary acute angle-closure glaucoma in 43 cases

【Objective】To analyze the natural course primary acute angle-closure glaucoma and explore the risk factors,diagnosis and treatment and curative effects.【Methods】A retrospective survey of forty-three patients（fortyfive eyes） with primary acute angle-closure glaucoma（PACG） were studied.Onset,causes,treatments and curative effects were analyzed,【Resluts】Since two patients suffered bilateral PACG,so 43 cases with 45 eyes were studied.Eleven were male while thirty-two were female.The age was between forty-two and eighty.Three patients have clearly family history,5 cases induced by overwork or lack of rest,3 cases by emotional excitement,2 cases by mydriasis and 2 cases by other surgery.Only seven patients（15.56%） required medical treatment while 36 cases（83.72%） were underwent surgical treatment.Vision acurity was improved obviously in most patient s（93%） of medical treatment group while 3 cases（7%） not.In addition,2 cases acquired good vision acuity and normal intraocular pressure while 5 ones failed to have vision acurity improvement and intraocular pressure reduction.What＇s worse a-mid-pulil were observed only in several cases of these 5 ones.However,dilated fixed pupils and atrophy of iris were maintained in 11 patients（25.6%） of treatment groups.【Conclusion】Middle and aged women are more often affected PACG than men.Overwork,emotional excitement,mydriasis and so on may induce PACG acute attacks.Since visual function can be damaged dramaticly after that,then early diagnosis and early treatment appear more imporment.