恶性青光眼发病机制及临床分型的研究

目的 研究恶性青光眼的发病机制，为它的临床分类提供依据。方法 采用眼科超声生物显微镜、眼科Ａ，Ｂ型超声以及眼科临床检查方法及诊断性手术对１２例恶性青光眼病例进行了活体眼部解剖结构的定性及定量观察，并采用对照研究的方法和对侧眼进行了比较研究，按照观察结果结合临床表现对恶性青光眼的分类提出了新的建议。结果 在１２例病例中有４例（３３．３％）经超声生物是微镜证实存有睫状环阻滞的特征，且对侧眼存在眼前段侠

Pathogenesis and Clinical Classification of the Malignant Glaucoma

Purpose: To study the pathogenesis of the malignant glaucoma and the basis for the clinical classification of malignant glaucoma. Methods: Twelve eyes with malignant glaucoma were examed by ultrasound biomi-croscopy (UBM), type A and type B ocular ultrasounographer and other clinical ophthalmic tests and diagnostic therapy. The ocular anatomic structures of all 12 eyes were compared with those of the fellow eyes. Results: Ciliary block were confirmed in four of the twelve eyes (33. 3% ) with malignant glaucoma while the narrow and small anterior segment were found in the fellow eyes by UBM. Iris lens disphragm anterior displacement were found in the other eight of the twelve eyes (76. 6% ) and their ciliary bodies were deformed passively. The ciliary bodies and anterior segment of the fellow eyes of these eight eyes were anatomically normal. Diagnostic surgery was performed in seven of the twelve eyes and six cases with fluid existing in the vitreous cavity were identified. Conclusion: According to our study, we suggest to classify malignant glaucoma into two tyges. One is ciliary block, which caused by ciliary block and concerned with the narrow and small structure of the anterior segment of eye. The other is lens iris block, which caused by iris lens diaphragm anterior displacement. Both types have the same pathophysiologic characteristics, such as, shallow anterior chamber, posterior chamber disappearance and aqueous humor misdirection to the vitreous cavity. But their pathogengesis may not be completely same. Eye Science 1999; 15: 238- 241