摘要
目的 讨论抗青光眼术后睫状体脉络膜脱离与恶性青光眼的关系。方法 回顾性总结我院住院病人小梁切除术后睫状体脉络膜脱离并发恶性青光眼8例8只眼。结果 8只眼均于术后1月内出现扁平前房,周边虹膜与角膜内皮相贴,眼压24～50mmHg,平均295mmHg,其中7只眼行脉络膜上腔放液+前房注气术,1眼行白内障囊外摘出+人工晶状体植入+脉络膜上腔放液术,术中8眼均于脉络膜上腔放出淡黄色液体,术后前房加深,眼压降至正常。结论 睫状体脉络膜脱离可能是恶性青光眼发病过程中的一个步骤,或二者为同一病体中的两种表现。抗青光眼术后出现扁平前房,眼压正常或偏高应警惕恶性青光眼。脉络膜上腔放液治疗有效。
ObjectiveTo discuss the relationship between ciliochoroidal detachment and malignant glaucoma with normal or higher intraocular pressure(IOP) after glaucoma surgery.Methods8 eyes(8 cases) with ciliochoroidal detachment and malignant glaucoma after glaucoma surgery were reviewed retrospectively.All 8 eyes were angle closure glaucoma.After IOP was controlled to normal with topical pilicarpin,timolol and oral acetazolamide,8 eyes received trabeculectomy under topical anesthenia and were treated with antibiotics,corticosteriods and eycloplegics.Results8 eyes showed flat anterior chamber,high IOP(mean 29 5*!mmHg,range 24～50 mmHg),iridocorneal apposition at one month after trabeculectomy.Of 8 eyes,7 were treated with drainage of surachoroidal fluid and gas injection into anterior chamber,1 was treated with extracapsular cataract extraction,intraocular lens implantation,drainage of surachoroidal fluid and gas injection into anterior chamber.Surachoroidal fluid was seen during sleostomy in 8 eyes.After the second surgery,8 eyes were treated with topical antibiotics corticosteriods,eyoloplegics,anterior chamber was deeper,and IOP was normal again.ConclusionCiliochoroidal detachment may be a step of the development of malignant glaucoma,or both of them may be the same disease with variations of clinical appearances;Malignant glaucoma should be considered in different diagnosis of a flat or shallow anterior chamber with normal or higher IOP after glaucoma surgery.Drainage of surachoroidal fluid is effective.
出处
《眼科研究》
CSCD
2000年第1期81-82,共2页
Chinese Ophthalmic Research
关键词
睫状体
脉络膜脱离
恶性
青光眼
闭角型
glaucoma surgery ciliochoroidal detachment malignant glaucoma
