摘要
目的分析13例20只剥脱综合征眼的青光眼发生情况及其临床特点和治疗效果。方法回顾总结了13例20只剥脱综合征眼的青光眼发生率及其临床特点、治疗方法及疗效。结果13例20只剥脱综合征眼中合并青光眼10例13只,占65%,全部为开角型。眼压15.5～43.38mmHg,平均26.13mmHg。眼底视盘C/D0.3～1.0,其中≥0.6者8眼,占40%,0.8～～1.0者6只眼,占30%。4只眼行单纯超声乳化白内障摘除术后眼压下降。1眼行小梁切除术,术后眼压控制良好。2眼曾行小梁切除术,但术后眼压仍高,视神经进行性损害最终失明。1眼白内障术后眼压仍高,需应用药物。结论剥脱综合征具有较高的青光眼发生率,其眼压难于控制、视野进行性损害迅速、对药物治疗反应差,应及早手术干预。对于处在较早期、较轻微的、视神经尚未严重损害者,单纯超声乳化白内障手术有效,对于已发生严重视神经损害者须行青光眼手术。
Objective To analyze the incidence of pseudoexfoliative glaucoma in 13 patients(20 eyes)with pseudoexfoliation syndrome,its clinical characteristic and results to different therapeutic methods.Methods 13 cases of pseudoexfoliation syndrome were reviewed.Results Among 13 cases(20 eyes),pseudoexfoliative glaucoma was occured in 10 cases(13 eyes)(65%)and totally presented with open anterior chamber angle.IOP ranged 15.5～43.38mmHg,means 26.13mmHg.C/D of optic disk ranged 0.3～1.0,≥0.6 8 eyes(40%),0.8～1.0 6 eyes(30%).IOP was reduced in 4 eyes after phacoemulsification who had elevated preoperative IOP with coexisting cataract.Trabeculectomy was performed in 1 eye whose IOP was well controlled after surgery.Trabeculectomy had been performed in 1case(2 eyes)before admission,but IOP was elevated and advanced optic nerve damage and blindness was present.Medication was needed in 1 case(1 eye)with elevated IOP who had been performed ECCE+PCIOL 1 year before.Conclusions There is a high incidence of pseudoexfoliative glaucoma in patients with pseudoexfoliation syndrome,IOP levels,visual field defect and optic nerve damage in pseudoexfoliative syndrome was severe and more resistant to medication,the operation should be intervened in early stage.In patients with pseudoexfoliation syndrome,a visually significant cataract,and no advanced optic nerve damage,phacoemulsification alone is a reasonable option for initial IOP management.Anti-glaucoma operation should be used in those cases with advanced optic nerve damage and unsatisfactorily controlled IOP.
出处
《中国实用眼科杂志》
CSCD
北大核心
2005年第5期490-493,共4页
Chinese Journal of Practical Ophthalmology
