CAJ | 학술논문

目的：探讨高眼压青光眼滤过手术中恶性青光眼的手术处理，应用前房注气技术联合可调整缝线，可解除睫状环阻滞，减少恶性青光眼的发生。 　　方法：高眼压闭角型青光眼患者30例，初诊眼压大于60mmHg，经详细检查，符合复合式小梁切除手术适应证，药物降眼压，手术前眼压大于45 mmHg。采用复合式小梁切除术，手术中完成巩膜瓣缝线后，出现无前房高眼压（睫状环阻滞）状态，采取加缝巩膜瓣可调整缝线并行前房注射消毒空气形成前房。 　　结果：术后随访6mo，30例均未出现恶性青光眼，前房深度稳定，25例眼压小于18mmHg，5例滤泡局限后眼压22～28 mmHg。 　　结论：高眼压状态下行青光眼滤过手术，手术中出现高眼压无前房（睫状环阻滞）状态的机会很高，本文通过集中归纳30例此类手术情况，认为手术中加缝巩膜瓣可调整缝线并采用前房注射消毒空气形成前房的方法可以缓解术中睫状环阻滞，避免此类青光眼术后发生恶性青光眼情况。
목적：탐토고안압청광안려과수술중악성청광안적수술처리，응용전방주기기술연합가조정봉선，가해제첩상배조체，감소악성청광안적발생。 　　방법：고안압폐각형청광안환자30례，초진안압대우60mmHg，경상세검사，부합복합식소량절제수술괄응증，약물강안압，수술전안압대우45 mmHg。채용복합식소량절제술，수술중완성공막판봉선후，출현무전방고안압（첩상배조체）상태，채취가봉공막판가조정봉선병행전방주사소독공기형성전방。 　　결과：술후수방6mo，30례균미출현악성청광안，전방심도은정，25례안압소우18mmHg，5례려포국한후안압22～28 mmHg。 　　결론：고안압상태하행청광안려과수술，수술중출현고안압무전방（첩상배조체）상태적궤회흔고，본문통과집중귀납30례차류수술정황，인위수술중가봉공막판가조정봉선병채용전방주사소독공기형성전방적방법가이완해술중첩상배조체，피면차류청광안술후발생악성청광안정황。
AIM:To investigate the surgical treatment in filtering operation for malignant glaucoma with high intraocular pressure.Application of anterior chamber gas injection technology combined with adjustable suture can relieve ciliary blockand reduce the occurrence of malignant glaucoma. METHODS:A total of 30 cases of closed-angle glaucoma patients with high intraocular pressure were selected as research objectives. Their intraocular pressure were >60mmHg at the first time.After detailed inspection those patients met the indications of compound trabeculectomy and were given drugs to reduce intraocular pressure with the preoperative intraocular pressure >45mmHg. The compound trabeculectomy were performed in those patients.After completion of the operation of scleral flap suture, it formed a state of intraocular hypertension with no anterior chamber ( ciliary block ) .By suturing scleral flap with adjustable suture line and injecting sterile air into anterior chamber, anterior chamber was formed. RESULTS: During the follow-up of 30 cases in six months, there were no malignant glaucoma; anterior chamber depth was stable; 25 cases of intraocular pressure were less than 18mmHg; 5 cases of IOP after follicular limitation were between 21-28mmHg. CONCLUSION:If filtering surgery for closed -angle glaucoma is performed at a state of high intraocular pressure, the incidence of state of high intraocular pressure with no anterior chamber ( ciliary block ) state will be very high.By summarizing the 30 cases of this kind of surgery, this paper held that this method ( suture of the scleral flap with adjustable suture combined with injection of sterile air in anterior chamber ) can relieve ciliary block in the operation and avoid the occurrence of malignant glaucoma after this kind of operation.