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青光眼滤过术后的驱逐性出血

Expulsive hemorrhage after glaucoma filtering surgery.

作者信息

Jiraskova Nada, Rozsival Pavel, Pozlerova Jana, Ludvikova Marie, Burova Mariya

机构信息

Department of Ophthalmology, University Hospital, Hradec Kralove, Czech Republic.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2009 Sep;153(3):221-4. doi: 10.5507/bp.2009.038.

Abstract

AIMS

To evaluate the incidence, patient risk factors, diagnosis and management of suprachoroidal hemorrhage (SCH) after glaucoma filtering surgery.

METHODS

Retrospective case series study comprised 1553 eyes having glaucoma filtering surgery during the last 15 years (between January 1993 and December 2007) at our department. Observations included incidence, patient risk factors, peri and postoperative diagnosis, management, and outcomes of SCH after this procedure.

RESULTS

Two cases of SCH were revealed. In one eye SCH developed at the end of surgery, in the other eye in the postoperative period. Both patients had systemic and ocular risk factors (hypertension, high preoperative intraocular pressure, myopia, pseudoexfoliation, aphakia or pseudophakia). Visual functions improved in the case of intraoperative SCH over 2 months withouth surgical intervention, in the eye with delayed postoperative SCH visual outcome was poor despite multiple lavages of anterior chamber and vitreous cavity.

CONCLUSION

Suprachoroidal hemorrhage, both expulsive and delayed, is a rare, but severely debilitating complication of glaucoma surgery.

摘要

目的

评估青光眼滤过术后脉络膜上腔出血(SCH)的发生率、患者危险因素、诊断及处理方法。

方法

回顾性病例系列研究,纳入了过去15年(1993年1月至2007年12月)在我科接受青光眼滤过手术的1553只眼。观察内容包括该手术后SCH的发生率、患者危险因素、围手术期及术后诊断、处理方法及结果。

结果

发现2例SCH。1例在手术结束时发生,另1例在术后发生。两名患者均有全身及眼部危险因素(高血压、术前高眼压、近视、假性剥脱、无晶状体或人工晶状体眼)。术中发生SCH的患眼在未进行手术干预的情况下,2个月内视功能改善;术后延迟发生SCH的患眼尽管对前房和玻璃体腔进行了多次冲洗,视觉预后仍较差。

结论

无论是暴发性还是延迟性脉络膜上腔出血,都是青光眼手术罕见但严重致残的并发症。

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