睫状环阻滞性青光眼的阶梯治疗临床分析

目的　探讨睫状环阻滞性青光眼的临床治疗方法及效果分析。方法　回顾性分析２００６年３月至２０１３年６月经我院治疗的１４眼睫状环阻滞性青光眼的临床资料，首先采用药物治疗，治疗无效者及时手术治疗。手术方法:抽吸玻璃体水囊联合前房重建术４例４眼；前段玻璃体切割联合白内障超声乳化联合人工晶状体植入联合局部后囊切开术（对于人工晶状体眼采取晶状体后囊切开联合前部玻璃体切割术）４例４眼。结果　经药物治疗后，６眼病情得到缓解，４眼在药物治疗的同时行玻璃体内水囊抽吸联合前房重建术；４眼在上述治疗无效基础上进一步手术治疗，其中３眼行前段玻璃体切割联合白内障超声乳化联合人工晶状体植入联合局部后囊切开术，另１眼为白内障术后患者，行后囊切开联合前部玻璃体切割术。术后随访３～６个月，术后眼压（１６．３７８±４．３０８）ｍｍＨｇ（１ｋＰａ＝７．５ｍｍＨｇ），与术前（３６．５３９±２．７３９）ｍｍＨｇ差异有统计学意义（Ｐ＜０．０５）；术后前房深度全部恢复正常且稳定（２．４２３±０．３７９）ｍｍ，与术前（０．６１３±０．１８５）ｍｍ差异有统计学意义（Ｐ＜０．０５）。结论　对于术后发生的睫状环阻滞性青光眼，采取由简单到复杂的阶梯式治疗，能够取得较好的临床疗效。

Clinical analysis of ladder treatment in ciliary block glaucoma

Objective To investigate the clinical treatment and effect of ciliary block glaucoma. Methods A retrospective analysis of clinical data from March 2006 to June 2013 in our hospital were performed in 14 eyes with ciliary block glaucoma , the drug therapy was first used , or timely operation treatment when drug weren ’ t effective. Operation methods : Aspiration of vitreous water bag associate with anterior reconstruction in 4 eyes ;The anterior vitrectomy combined with phacoemulsification and intraocular lens implantation combined with partial capsulotomy ( for artificial crystal eyes taking posterior capsular incision combined with anterior vitrectomy) in 4 eyes. Results The diseases got alleviation after drug treatment in 6 eye, aspiration of vitreous water bag associate with anterior reconstruction were adopted at the same time with the drug treatment in 4 eyes; Further surgery in 4 eyes were adopted when the above treatment was invalid.of which 3 eyes had the anterior vitrectomy combined with phacoemulsification and intraocular lens implantation combined with partial capsulotomy, the other one had the anterior vitrectomy combined with capsulotomy. the patients were followed up from 3 months t0 6 months , the preoperative and postoperative intraocular pressure were ( 36. 539 + 2. 739 ) mmHg ( I kPa = 7. 5 mmHg ) and ( 16. 378 + 4. 308 ) mmHg, there was statistical difference(P < 0. 05 ) . The preoperative and postoperative anterior chamber depth were ( 0. 613 + 0. 185 ) mm and ( 2. 423 + 0. 379 ) mm . there was statistical difference(P < 0. 05 ) . Conclusion The escalation therapy from simple to complex for the ciliary block glaucoma after operation can achieve the better clinical effects.