摘要
目的探讨先天性小眼球眼部表现特点与合并症的治疗。方法回顾性分析在北京协和医院眼科诊断为先天性小眼球的11例(20眼)患者的临床资料,眼部检查包括视力、眼压、裂隙灯显微镜、眼底、A型和B型超声波及超声活体显微镜等。平均随访33个月。结果初诊视力无光感者2眼,光感～0.1者12眼,0.2～0.5者2眼,0.6～1.0者3眼,1.2者1眼。初诊眼压:8～21mmHg(1kPa=7.5mmHg)者7眼,22～40mmHg者4眼,40mmHg以上者9眼。裂隙灯显微镜检查:20眼小睑裂,9眼小角膜,20眼浅前房。20眼均合并闭角型青光眼及白内障。眼底检查:12眼因屈光间质混浊眼底不能窥入;8眼视盘C/D为0.3～0.9,1眼合并先天性视网膜劈裂。20眼眼轴长度为15.87～20.38mm,平均18.00mm。13眼施行小梁切除术,术后眼压控制在23mmHg以下9眼。11眼行白内障摘出术,其中5眼联合人工晶状体植入术。术后矫正视力提高7眼,其中提高至0.9～1.0者3眼,0.05～0.10者4眼。结论先天性小眼球眼轴短(眼轴长度≤20.50mm)、晶状体大及巩膜厚,多合并闭角型青光眼和白内障等。合并症的手术风险高,术前充分降低眼压,术中酌情先行后巩膜切开术,可降低术中或术后风险,有望提高手术成功率。
Objective To assess the ocular manifestation of congenital microphthalmos（CM）and its complications treatment.Methods Retrospective case series were taken to study the clinical data of 11 patients（20 eyes）of CM at Peking Union Medical College Hospital with an average follow up of 33 months,examination including visual acuity,intraocular pressure（IOP）,slit-lamp,fundus,A-scan,B-scan,and ultrasonic biomicroscope.Results Preliminary visual acuity：No light perception in 2 eyes,from light perception to 0.1 in 12 eyes,from 0.2 to 0.5 in 2 eyes,from 0.6 to 1.0 in 3 eyes,1.2 in 1 eye.Initial IOP：From 8 mmHg（1 kPa=7.5 mmHg）to 21 mmHg in 7 eyes,from 22 mmHg to 40 mmHg in 4 eyes,above 40 mmHg in 9 eyes.Slit-lamp biomicroscope demonstrated narrow palpebral fissure in 20 eyes,microcornea in 9 eyes,flat anterior chamber in 20 eyes,angle-closure glaucoma and cataract in 20 eyes.The fundus examination revealed congenital retinoschisis in 1 eye,C/D from 0.3 to 0.9 in 8 eyes,and 12 eyes no seeing into the fundus.The average axial length was 18.00 mm（from 15.87 mm to 20.38 mm）.Trabeculectomy was conducted in 13 eyes with control of postoperative IOP in 9 eyes.Cataract extraction was performed in 11 eyes with the visual acuity improved in 7 eyes,including from 0.9 to 1.0 in 3 eyes,from 0.05 to 0.10 in 4 eyes.Conclusion CM is characterized by short axial length,high lens to eye volume and thickened sclera.It appears with more complications of poor treatment and high surgical risks.Surgery achievement ratio will be elevated if given the correct preoperative treatment.
出处
《眼科新进展》
CAS
北大核心
2011年第5期485-487,共3页
Recent Advances in Ophthalmology
关键词
先天性小眼球
闭角型青光眼
白内障
congenital microphthalmos； angle-closure glaucoma； cataract
