Nd:YAG激光治疗白内障术后恶性青光眼

目的评价Nd:YAG激光治疗白内障术后恶性青光眼的效果。方法回顾性分析12例(12眼)白内障术后恶性青光眼施行Nd:YAG激光晶体后囊膜及玻璃体前界膜切开术后眼压、前房变化及视力恢复情况。结果经过Nd:YAG激光治疗后所有病例在术后半小时至1小时内形成前房,眼压明显降低,视力部分恢复;8眼在术后2周内前房稳定,眼压得到控制,视力继续提高,继续随访1年未复发;4眼激光治疗后复发,再次激光治疗后1眼治愈,3眼再次复发;此3眼行玻璃体切割手术治愈。结论激光后囊膜及玻璃体前界膜切开对多数白内障术后恶性青光眼治疗有效,操作简便易行,复发病例重复激光治疗仍有较好效果,可以作为白内障术后恶性青光眼的首选治疗方法。

The Treatment of malignant glaucoma after cataract surgery by Nd: YAG laser

Objective To evaluate the effect of laser approach in the postcataract malignant glaucoma. Methods Twelve cases postcataract malignant glaucoma by Nd: YAG laser capsulotomy and hyaloidotomy were analyzed . The visual acuity, anterior chamber and intraocular pressure were studied before and after treatment. Results Resolution was achieved in all eyes after treatment with Nd: YAG laser during half an hour to one hour. Eight eyes got better in the following 2 weeks and did not recur during 1 year. Four recurrence eyes treated in the same way and three eyes recurred again. The three cases underwent anterior vitrectomy immedi- ately after laser treatment, no recurrences were observed during the follow-up. Conclusions Nd: YAG laser capsulotomy with hyaloidotomy is effective to postcataract malignant glaucoma. Recurrent cases can be treated again. The same treatment appears to control intraocular pressure before anterior vitrectomy in recurrent cases. The visual outcome, anterior chamber and intraocular pressure were satisfying.