摘要
目的:探讨原发性慢性闭角型青光眼年轻患者临床治疗的经验和体会。方法:对2000-01/2005-12中山眼科中心临床收治的38例50眼、年龄<40岁、临床确诊为进展期或晚期原发性慢性闭角型青光眼的患者、进行抗青光眼手术处理的病例进行回顾性分析。随访时间平均(23.6±7.5)mo;所有的病例都有完善的眼科检查。临床结果评价包括临床特点、手术结果和并发症。结果:患者平均年龄为(33.5±6.1岁;女性占60.5%;眼轴长平均(22.4±3.5)mm,其中短眼轴占18.0%,小眼球占14%;有60%的患者为浅前房(<1.9mm);超声生物显微镜检查高褶虹膜构型占80.6%,手术前后眼压差异有统计学意义(P<0.001)。4眼因眼压控制不理想,行二次抗青光眼手术治疗。术后并发症主要有浅前房(20%),恶性青光眼(12%)。结论:对进展期或晚期的年轻原发性慢性闭角型青光眼患者进行复合式小梁手术治疗是行之有效的手段,但术后容易出现浅前房、恶性青光眼。术前详细检查、手术操作精细以及有效处理术后并发症将有助于提高手术成功率和减少并发症。
AIM： To evaluate the clinical outcomes of management in younger patients with primary chronic angle-closure glaucoma （PCACG）.
METHODS： Thirty-eight patients （50 eyes） aged 40 or younger with confirmed diagnosis of PCACG in advanced or late stage who received surgical treatment in Zhongshan Ophthalmic Center from .lanuary 2000 to December 2005 were retrospectively investigated. All patients underwent trabeculectomy. The mean follow-up was 23.6±7.5 months. Full ophthalmic examinations were performed. The clinical outcomes including clinical presentations, surgical results and complications were evaluated.
RESULTS： The mean age of patients was 33.5±6.1 years old. There was a female preponderance （60.5%）. The mean axial length was 22.4±3.5mm with 18.0% short axis of eyeball and 14% nanophthalmos. There was 60,0% flat anterior chamber depth （〈1.9mm）. Ultrasonic Biomicroscopy identified that plateau iris was the most common underlying etiology （80.6%）. There was a statistically significant difference in intraocular pressure （IOP） reduction postoperatively vs preoperatively （P〈 0.001）. Four eyes failed to control IOP and received second filtration surgery. The main postoperative complications included shallow anterior chamber （20.0%） and malignant glaucoma （12.0%）.
CONCLUSION： The younger PCACG patients in advanced or late stage can be effectively managed by trabeculectomy. They have more frequency of postoperative sustained shallow anterior chamber and malignant glaucoma, Careful ophthalmic examinations, delicate surgical procedures and well-managed technique of complications were suggested on younger PCACG patients.
出处
《国际眼科杂志》
CAS
2007年第3期613-617,共5页
International Eye Science
基金
中国广东省科技计划项目国际合作项目(No.2006B60501003)~~
