CAJ | 학술논문

目的：：探讨恶性青光眼治疗方法的选择。方法：设计回顾性病例分析,回顾分析2012-05/2013-05在我院眼科中心接受治疗的21例恶性青光眼患者的临床资料,21例21眼恶性青光眼患者,发生于小梁切除术后16眼(76%),青光眼引流钉术后3眼(14%),青光眼引流阀术后2眼(10%)。主要指标矫正视力、眼压、前房深度及并发症。结果：患者13眼经药物治疗后眼压下降前房恢复,4眼行玻璃体水囊抽吸+前房成形术,2眼行白内障超声乳化+人工晶状体植入术,2眼(白内障术后)行前部玻璃体切除+后囊膜切开,术后均眼压下降恢复前房。眼压由治疗前29.81±4.98 mmHg 降至治疗后12.71±3.77 mmHg ( P=0.00),前房轴深由治疗前0.41±0.34 mm 升至治疗后2.13±0.54mm(P=0.00),术前矫正视力0.19±0.17,术后矫正视力0.20±0.16(P=0.36)。除1眼行玻璃体水囊抽吸后少量玻璃体出血,给予药物治疗后玻璃体出血吸收,余所有患者在治疗过程中及治疗后均未见明显眼部或全身不良反应。结论：及早发现恶性青光眼,采用循序渐进的方法治疗恶性青光眼效果明显,能够降低眼压,恢复前房。
목적：：탐토악성청광안치료방법적선택。방법：설계회고성병례분석,회고분석2012-05/2013-05재아원안과중심접수치료적21례악성청광안환자적림상자료,21례21안악성청광안환자,발생우소량절제술후16안(76%),청광안인류정술후3안(14%),청광안인류벌술후2안(10%)。주요지표교정시력、안압、전방심도급병발증。결과：환자13안경약물치료후안압하강전방회복,4안행파리체수낭추흡+전방성형술,2안행백내장초성유화+인공정상체식입술,2안(백내장술후)행전부파리체절제+후낭막절개,술후균안압하강회복전방。안압유치료전29.81±4.98 mmHg 강지치료후12.71±3.77 mmHg ( P=0.00),전방축심유치료전0.41±0.34 mm 승지치료후2.13±0.54mm(P=0.00),술전교정시력0.19±0.17,술후교정시력0.20±0.16(P=0.36)。제1안행파리체수낭추흡후소량파리체출혈,급여약물치료후파리체출혈흡수,여소유환자재치료과정중급치료후균미견명현안부혹전신불량반응。결론：급조발현악성청광안,채용순서점진적방법치료악성청광안효과명현,능구강저안압,회복전방。
Abstract?AlM:To investigate the choice of different treatments for malignant glaucoma.? METHODS: ln this retrospective case series, 21 malignant glaucoma patients ( 21 eyes ) admitted in Wuhan General Hospital of Guangzhou Military Command from May 2012 to May 2013 were analyzed. Sixteen eyes ( 76%) developed malignant glaucoma after filtration surgery, 3 eyes ( 14%) after EX - PRESS glaucoma filtration device, 2 eyes ( 10%) after glaucoma filtration Ahmed valve implantation. Main Outcome of corrected visual acuity, intraocular pressure ( lOP ) , anterior chamber depth and complications were detected.?RESULTS: lOP recovered by drug control in 13 eyes, anterior chamber depth. Four eyes were treated by vitreous water- bag aspiration combined with anterior chambers reconstructing. Two eyes were treated by cataract extraction and intraocular lens implantation. Two eyes were treated by posterior capsule excision combined with anterior vitrectomy. lOP before and after treatment was 29. 81±4. 98, 12. 71±3. 77mmHg, respectively (P=0. 00). Anterior chamber depth before and after treatment was 0.41± 0. 34, 2. 13 ± 0. 54mm, respectively (P = 0. 00). Corrected visual acuity before treatment was 0. 19 ± 0. 17, after treatment was 0. 20±0. 16 (P= 0. 36). Except for vitreous hemorrhage in 1 eye, there were no ocular or systemic adverse events observed in all patients.? CONCLUSlON: lt is good to diagnose malignant glaucoma in early period, and treated it step by step. For this can reduce lOP and restore anterior chamber.