CAJ | 학술논문

目的探讨青光眼小梁切除术后脉络膜脱离的原因及防治方法 .方法对242例(269眼)青光眼小梁切除术后发生的28例(32眼)脉络膜脱离进行回顾性分析.结果 28例(32眼)脉络膜脱离发生时间为术后1～5d,平均(3.21±1.22)d,术后脉络膜脱离的发生与术前眼压控制不佳、术中切口偏后及巩膜瓣偏薄有关.通过散瞳、抗炎、加压包扎、应用皮质类固醇及高渗剂等治疗而复位,1例Ⅲ度浅前房行脉络膜上腔放液前房形成而复位,均经UBM检查证实脉络膜下积液吸收.结论青光眼小梁切除术后脉络膜脱离与术前眼压高、术中手术操作不当有关.一般经保守治疗可得到治愈,而早期通过UBM检查发现并采取相应措施可避免严重并发症的发生.
목적 탐토청광안소량절제술후맥락막탈리적원인급방치방법 .방법 대242례(269안)청광안소량절제술후발생적28례(32안)맥락막탈리진행회고성분석.결과 28례(32안)맥락막탈리발생시간위술후1～5d,평균(3.21±1.22)d,술후맥락막탈리적발생여술전안압공제불가、술중절구편후급공막판편박유관.통과산동、항염、가압포찰、응용피질류고순급고삼제등치료이복위,1례Ⅲ도천전방행맥락막상강방액전방형성이복위,균경UBM검사증실맥락막하적액흡수.결론 청광안소량절제술후맥락막탈리여술전안압고、술중수술조작불당유관.일반경보수치료가득도치유,이조기통과UBM검사발현병채취상응조시가피면엄중병발증적발생.
Objective To investigate the causes and preventing methods of choroidal detachment after glaucoma filtrating surgery.Methods Glaucoma surgeries were performed in 269 eyes of 242 patients.The causes of 28 patients (32 eyes) complicated with choroidal detachment were discussed by retrospective analysis.Results Thirty-two eye of 28 patients were complicated by choroidal detachment postoperative 1 -5 days ( 3.21 ± 1.22) d.The reasons of choroidal detachment were relevant with poorly controlling of intraocular pressure before operation,backward incision and the thin sclera disc slants.Therapeutic methods were mydriasis,anti-inflammation,pressure bandage,corticosteroid and hyperosmotic solution.One patient with grade Ⅲ shallow anterior chamber was operated by suprachoroidal drainage.All of them proved by UBM.Conclusion The major reasons of choroidal detachment after glaucoma filtration surgery are high preoperative intraocular pressure and improper operation.UBM could effectively detect complications in early stage.