角膜内皮炎合并青光眼的临床分析

目的探讨角膜内皮炎合并青光眼的病因、临床表现及治疗。方法回顾性分析2008年1月至2009年1月来我院收治的19例（20只眼）角膜内皮炎合并青光眼患者的临床表现、具体治疗措施及疗效。结果所有患者均有角膜内皮损害的典型症状,伴有眼压升高、视野缺损,经抗病毒药物、糖皮质激素药物联合前房穿刺术或小梁切除治疗后,随访8个月至1.5年,药物治疗有5只眼复发（45.45%）,视力提高5只眼（45.46%）,角膜透明3只眼（18.18%）;前房穿刺术1只眼复发（25.00%）,视力提高2只眼（50.00%）,角膜透明2只眼（50.00%）;小梁切除术者无复发,视力提高3只眼（60.00%）,角膜透明4只眼（80.00%）。所有患者均能较好的控制眼压,症状改善,晚期复发率低。结论角膜内皮炎的诊断目前缺乏针对性的检查手段,主要为药物治疗;如合并青光眼,应用抗病毒药物及糖皮质激素药物联合前房穿刺术或小梁切除术治疗,能取得良好的临床治疗效果。

Clinical Investigation and treatment of corneal endotheliitis comply with glaucoma

Objective To analyze the pathogeny of corneal endotheliitis comply with glaucom and to investigate the key to treatment.Methods 19 cases（20 eyes）,the clinical manifestation and treatment of corneal endotheliitis comply with glaucom were analysised retrospectively.Results All cases had the typical clinical manifestation of corneal endothelium disfunction,comply with high ocular pressure、visualfields disfuction.Cases were cured through treatment by drug（steroid and anti-virus agent）、paracentesis of anterior chamber or glaucoma filtration surgery.Treatment by drug,recurrence appeared in 5 eyes（45.45%）,visual acuity increased 5 eyes（45.46%）,corneal cleared 3 eyes（18.18%）;Treatment by paracentesis of anterior chamber,recurrence appeared in 1 eyes（25.00%）,visual acuity increased 2 eyes（50.00%）,corneal cleared 2eyes（50.00%）;Treatment by glaucoma filtration surgery,recurrence appeared in 0 eyes（00.00%,visual acuity increased 3 eyes（60.00%）,corneal cleared 4 eyes（80.00%）.Conclusions The diagnosis and pathogeny of corneal endotheliitis is unclear yet.The key treatment is drug（steroid and anti-virus agent）;If complied with glaucom which clinical treatment was paracentesis of anterior chamber or glaucoma filtration surgery.