前房穿刺术治疗急性闭角型青光眼急性发作的临床分析

目的:探讨前房穿刺放液处理急性闭角型青光眼的急性发作的疗效及时机。方法:对30例30眼急性闭角型青光眼的急性发作的患者(术前眼压均≥60mmHg,1kPa=7.5mmHg)在联合应用常规降眼压药物治疗未能有效降低眼压后采用15°穿刺刀在8倍放大倍率的手术显微镜下进行前房穿刺,轻压切口后唇缓慢放出房水。结果:所有患者经前房穿刺放液后高眼压及眼痛迅速缓解,视力不同程度提高,其中12眼>0.3,10眼0.1～0.3,8眼<0.1,术后眼压平均16mmHg,其中3眼穿刺后5～8h眼压再次升高遂再次放液。结论:采用15°穿刺刀在手术显微镜下前房穿刺放液比传统的注射针头穿刺放液损伤小反应轻,是治疗急性闭角型青光眼的急性发作期的辅助措施,可以缩短降眼压的时间以减轻患者痛苦,减轻因高眼压造成的视功能损害,避免了长时间大量应用常规降眼压药物可能引起的副作用,为青光眼进一步治疗创造了条件。

Clinical analysis of anterior chamber penetration for treating sudden attack of acute angle-closure glaucoma

AIM:To evaluate the clinical effects and opportunity of anterior chamber penetration for treating the sudden attack of acute angle-closure glaucoma. ·METHODS:Anterior chamber penetration by using 15° acupuncture knife was performed on thirty patients with the sudden attack of acute angle-closure glaucoma after topical anaesthetic. The mean intraocular pressure(IOP) was over 60mmHg(1kPa=7.5mmHg) before the penetration.·RESULTS:The mean postoperative IOP was 16mmHg as soon as the penetration was finished and the visual acuity was improved in all patients,of which above 0.3 were in 12 eyes,0.1-0.3 in 10 eyes,below 0.1 in 8 eyes.The IOP was increased again after 5-8 hours in 3 eyes.None of the patients felt painful during the operation and no complications occurred. ·CONCLUSION:Anterior chamber penetration using acupuncture knife is one kind of effective,safe and simple method for treating the sudden attack of acute angle-closure glaucoma.