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[先天性青光眼:视力与眼压的未来。一项11年研究的结果]

[Congenital glaucoma: future of vision and pressure. Results of an 11-year study].

作者信息

Tourame B, Ben Younes N, Guigou S, Denis D

机构信息

Service d'Ophtalmologie, CHU Nord, Marseille.

出版信息

J Fr Ophtalmol. 2009 May;32(5):335-40. doi: 10.1016/j.jfo.2009.03.023. Epub 2009 May 17.

Abstract

AIM

To study the future of vision and IOP in congenital glaucoma.

MATERIAL AND METHODS

We studied 33 eyes from 20 separate patients divided into two groups: group one consisted of 19 eyes with isolated trabeculodysgenesis and group two 14 eyes associated with Sturge-Weber-Krabbe syndrome, angiomatosis, or Peters syndrome. All patients underwent filtering surgery between 1995 and 2006. We studied a number of different forms of surgery; visual acuity after amblyopia treatment (> or =5/10, good; 4/10-2/10, average; < or =1/10, poor), objective refraction, and intraocular pressure (<16 mmHg, good; > or =16 mmHg, poor).

RESULTS

We found that 54.8% of the patients had visual acuity 5/10 or greater and 44.2% between 4 and the ability to perceive light. Objective refraction was emmetropic in 19.4% (group 1, 60%; group 2, 40%), myopic in 53.8% (group 1, 28.5%; group 2, 71%), and hyperopic in 26.9% of cases (100%, group 1). All patients underwent surgery (45.5% deep sclerectomy and 54.5% trabeculectomy); 39.4% of the patients underwent more than one type of surgery (the number of operations is a prognosis factor for visual acuity). IOP was less than 19 mmHg in 87.9% of eyes.

DISCUSSION

Visual acuity, refractive errors, and IOP depend on the type of congenital glaucoma. Isolated trabeculodysgenesis seems to give a better prognosis.

CONCLUSION

If early diagnosis and treatment occur, visual acuity that is 5/10 or less can be expected for more than 50% of patients; therefore their visual future seems to be better.

摘要

目的

研究先天性青光眼患者视力和眼压的预后情况。

材料与方法

我们对来自20例不同患者的33只眼睛进行了研究,将其分为两组:第一组包括19只单纯小梁发育异常的眼睛,第二组包括14只合并斯-韦-克综合征、血管瘤病或彼得斯综合征的眼睛。所有患者均在1995年至2006年间接受了滤过手术。我们研究了多种不同的手术方式;弱视治疗后的视力(≥5/10,良好;4/10 - 2/10,一般;≤1/10,差)、客观验光以及眼压(<16 mmHg,良好;≥16 mmHg,差)。

结果

我们发现54.8%的患者视力≥5/10,44.2%的患者视力在4/10至能感知光线之间。客观验光结果显示,19.4%的患者为正视眼(第一组,60%;第二组,40%),53.8%的患者为近视眼(第一组,28.5%;第二组,71%),26.9%的患者为远视眼(第一组为100%)。所有患者均接受了手术(45.5%为深层巩膜切除术,54.5%为小梁切除术);39.4%的患者接受了不止一种手术方式(手术次数是视力预后的一个因素)。87.9%的眼睛眼压低于19 mmHg。

讨论

视力、屈光不正和眼压取决于先天性青光眼的类型。单纯小梁发育异常似乎预后较好。

结论

如果能早期诊断和治疗,超过50%的患者有望获得≥5/10的视力;因此他们的视力预后似乎较好。

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