CAJ | 학술논문

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(＜1.9 mm);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.
목적:탐토원발성만성폐각형청광안년경환자림상치료적경험화체회.방법:대2000-01/2005-12중산안과중심림상수치적38례50안、년령＜40세、림상학진위진전기혹만기원발성만성폐각형청광안적환자、진행항청광안수술처리적병례진행회고성분석.수방시간평균(23.6±7.5)mo;소유적병례도유완선적안과검사.림상결과평개포괄림상특점、수술결과화병발증.결과:환자평균년령위(33.5±6.1세;녀성점60.5%;안축장평균(22.4±3.5)mm,기중단안축점18.0%,소안구점14%;유60%적환자위천전방(＜1.9 mm);초성생물현미경검사고습홍막구형점80.6%,수술전후안압차이유통계학의의(P＜0.001).4안인안압공제불이상,행이차항청광안수술치료.술후병발증주요유천전방(20%),악성청광안(12%).결론:대진전기혹만기적년경원발성만성폐각형청광안환자진행복합식소량수술치료시행지유효적수단,단술후용역출현천전방、악성청광안.술전상세검사、수술조작정세이급유효처리술후병발증장유조우제고수술성공솔화감소병발증.
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 January 2000 to December 2005were 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% fiat 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 postoperativelyvs 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.