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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.

DOI:10.1016/j.jfo.2009.03.023
PMID:19769870
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。

相似文献

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[Congenital glaucoma: future of vision and pressure. Results of an 11-year study].[先天性青光眼:视力与眼压的未来。一项11年研究的结果]
J Fr Ophtalmol. 2009 May;32(5):335-40. doi: 10.1016/j.jfo.2009.03.023. Epub 2009 May 17.
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[Trabeculectomy in congenital glaucoma: retrospective medium and long-term results].[先天性青光眼小梁切除术:回顾性中长期结果]
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Outcome of surgery on infants younger than 1 month with congenital glaucoma.1个月以下先天性青光眼婴儿的手术结果
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Surgical management of glaucoma in infants and children with Peters' anomaly: long-term structural and functional outcome.彼得斯异常患儿青光眼的手术治疗:长期结构和功能转归
Ophthalmology. 2004 Jan;111(1):112-7. doi: 10.1016/j.ophtha.2003.02.002.
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Temporal corneal phacoemulsification combined with superior trabeculectomy: a controlled study.颞侧角膜超声乳化术联合上方小梁切除术:一项对照研究。
Trans Am Ophthalmol Soc. 1996;94:451-63; discussion 463-8.
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[Long-term effect of trabeculotomy on primary congenital glaucoma].小梁切开术对原发性先天性青光眼的长期影响
Zhonghua Yan Ke Za Zhi. 2004 Nov;40(11):733-6.
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Deep sclerectomy combined with trabeculectomy in pediatric glaucoma.儿童青光眼的深层巩膜切除术联合小梁切除术
Ophthalmology. 2009 Jan;116(1):30-8. doi: 10.1016/j.ophtha.2008.08.039. Epub 2008 Nov 17.
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Combined trabeculotomy and trabeculectomy in advanced primary developmental glaucoma with corneal diameter of 14 mm or more.小梁切开术与小梁切除术联合应用于角膜直径14毫米及以上的晚期原发性发育性青光眼。
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Long-term surgical and visual outcomes in Indian children with developmental glaucoma operated on within 6 months of birth.印度出生6个月内接受手术治疗的发育性青光眼患儿的长期手术和视觉预后
Ophthalmology. 2004 Feb;111(2):283-90. doi: 10.1016/j.ophtha.2003.05.027.
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