原发性窄角型开角型青光眼临床特点分析

目的分析原发性窄角型开角型青光眼的临床特点。方法收集2001年12月-2006年4月在许昌市中心医院治疗的原发性窄角型开角型青光眼47眼的临床资料,进行总结、分析。结果①房角镜情况：房角结构全部可见13眼,可以看到巩膜突25眼,只能看到全部小梁和光切线移位9眼。②首次就诊确诊16眼,误诊31眼。误诊情况如下：误诊为急性闭角型青光眼急性发作的4眼,误诊为急性闭角型青光眼慢性期的9眼,误诊为慢性闭角型青光眼14眼,已行周边虹膜切除后残余性青光眼4眼。③有急性发作者17眼,没有急性发作者30眼。④入院时的眼压平均为（49．54±4．48）mmHg，随访2年后的平均眼压为（16．25±4．86）mmHg，均没有用药。经统计学处理，手术前后的眼压差异有显著性（P〈0．01）。结论原发性窄角型开角型青光眼具有窄房角，眼压升高时小梁网开放；可以有急性发作，容易误诊；临床的确诊要靠房角镜检查；要按开角型青光眼进行治疗。

Clinical Manifestatation of Primary Narrow-open-angle Glaucoma

Objective To evaluate clinical characteristic of primary narrow-open-angle glaucoma.Methods The clinical information of 47 eyes of primary narrow-open-angle glaucoma diagnosed in our hospital between December 2001 and April 2006 were evaluated,and analyzed.Results ①Characteristics of anterrior chamber anger：all structure of anterrior chamber anger to be seen were 13 eyes,the scleral spur to be seen were 25 eyes,all trabecular mechwork to be seen were 9 eyes.②16 eyes were correctly diagnosed,31 eyes were incorrectly diagnosed.The characteristics of incorrectly diagnosis：4 eyes were wrongly identified as acute of AACG,9 eyes were wrongly identified as with chronic of AACG,14 eyes were wrongly identified as chronic ACG and 4 eyes have made peripheral iridectomy.③17 eyes have acutely breaking out,30 eyes have not acutely breaking out.④Intraocular pressure （IOP）：the average IOP of the patients admitted to hospital was 49.54±4.48 mm Hg;The average IOP of follow-up 2 years was （16.25±4.86）mm Hg.There was a significant difference between pre-operation and post-operation status.Conclusion The primary narrow-open-angle glaucoma had clinical manifestation of narrow-angle,the anterior chamber angle opened completely in IOP raising.It may have acutely breaking out,and easy incorrectly diagnosed,correctly diagnosed was relied on examination of angle of anterior chamber,it should be treated as primary open-angle glaucoma.