摘要
目的观察糖尿病患者在白内障手术后急性葡萄膜炎继发青光眼的治疗方法及效果。方法回顾性研究。深圳市眼科医院2008年1月至2020年8月诊治的糖尿病患者白内障31例(31眼),均行超声乳化人工晶状体植入术,术后发生急性葡萄膜炎继发青光眼,观察发病时间、治疗方法及其效果。结果31例发病时间为4~7(5.00±2.30)d。就诊时视力为光感~0.05,眼压38~50(43.00±13.90)mmHg(1 mmHg=0.133 kPa)。及时给予药物降眼压、局部抗炎和散瞳治疗后症状无改善。其中19眼行瞳孔区渗出膜YAG激光切开术,另12眼激光切开术无效后行周边虹膜切除联合虹膜粘连分离术。术后31眼眼压均迅速下降,低于20 mmHg,前房纤维渗出物1~2周内完全吸收,视力0.15~1.0。结论YAG激光切开瞳孔区渗出膜或手术切除周边虹膜,解除瞳孔阻滞对糖尿病患者白内障手术后的急性葡萄膜炎继发青光眼治疗有效。
Objective To observe the treatment method and efficacy of secondary glaucoma with acute uveitic glaucoma after phacoemulsification in diabetics.Methods The data of acute uveitic glaucoma after phacoemulsification and intraocular lens implantation in patients with diabetes were analyzed in this retrospective study.The onset time,treatment methods and efficacy were observed.Results The onset time of all patients was 4 to 7 days,with an average of(5.00±2.30)days.The visual acuity was light perception to 0.05 and the IOP was 38-50(43.00±13.90)mmHg(1 mmHg=0.133 kPa)at the first visit.All cases received treatment of lowering intraocular pressure,the topical anti-inflammatory therapy and mydriasis.There was no improvement in the pupil,IOP and the visual acuity.Among them,19 cases received Nd:YAG laser iridotomy to remove exudative pupillary membrane,and the other 12 cases underwent peripheral iridectomy combined with iris adhesion separation.After operation,the IOP of the 31 cases decreased rapidly to below 20 mmHg,the anterior chamber fibrous exudate was completely absorbed within 1 to 2 weeks,and the visual acuity was basically restored to the pre-onset condition about 0.15 to 1.0.Conclusion YAG laser incision of the exudate membrane of pupil region or peripheral iridectomy to remove pupil block can effectively control the IOP and restore vision in diabetes with acute uveitic glaucoma after phacoemulsification.
作者
冯其高
冯丙岂
刘劲超
Feng Qigao;Feng Bingkai;Liu Jinchao(Shenzhen Eye Hospital,Shenzhen Eye Hospital Affiliated to Jinan University,Shenzhen Key Laboratory of Ophthalmology,Shenzhen 518040,China)
出处
《中华眼外伤职业眼病杂志》
2021年第9期711-714,共4页
Chinese Journal of Ocular Trauma and Occupational Eye Disease
