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118例恶性青光眼的回顾性临床分析

[Retrospective clinical analysis of 118 cases with malignant glaucoma].

作者信息

Zhang Wei-zhong, Huang Li, Ma Jian, Li Xiao-ning, Huang Jing-jing, Ge Jian

机构信息

Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2013 Feb;49(2):126-9.

PMID:23714028
Abstract

OBJECTIVE

To study the clinical characteristics and pathogenesis of malignant glaucoma in a 5-year retrospective analysis in Zhongshan Ophthalmic Center (ZOC).

METHODS

Medical records of 5-year malignant glaucoma patients in Zhongshan Ophthalmic Center were reviewed retrospectively. Patients' age, gender, original disease, duration before attack, axial length and the change of depth of anterior chamber, intraocular pressure and visual acuity before and after therapy and at final follow-up were checked and analyzed.

RESULTS

One hundred and eighteen cases of malignant glaucoma were hospitalized in ZOC from April 2005 to March 2010, accounts for 2.17% of PACG patients. Average age of malignant glaucoma patients was lower than that of PACG patients. The mean axial length of malignant glaucoma patients was shorter than that of Chinese population. Malignant glaucoma attacked between 1 day and 4.5 years after surgery. Ninety-three percent patients required medication and surgeries. Lens extraction and anterior vitrectomy were more effective than anterior chamber reforming combined with vitreous aspiration. The mean age of failed patient with vitreous cavity suction combined with anterior chamber angioplasty surgery was (43.7 ± 4.8) years, and was significantly younger than succeed patients, (53.7 ± 12.6) years (P < 0.05).

CONCLUSIONS

Malignant glaucoma are iatrogenic and nine tenths secondary to surgeries of PACG patients. Topical application of atropine is the first choice of medication. Lens extraction combined with anterior vitrectomy has more privileges, however, is not commended especially for younger patients.

摘要

目的

通过对中山大学中山眼科中心5年的回顾性分析,研究恶性青光眼的临床特征及发病机制。

方法

回顾性分析中山大学中山眼科中心5年内收治的恶性青光眼患者的病历。检查并分析患者的年龄、性别、原发病、发作前病程、眼轴长度以及治疗前后和末次随访时前房深度、眼压和视力的变化。

结果

2005年4月至2010年3月,中山大学中山眼科中心共收治恶性青光眼患者118例,占原发性闭角型青光眼患者的2.17%。恶性青光眼患者的平均年龄低于原发性闭角型青光眼患者。恶性青光眼患者的平均眼轴长度短于中国人群的平均眼轴长度。恶性青光眼在手术后1天至4.5年发作。93%的患者需要药物治疗和手术治疗。晶状体摘除联合前部玻璃体切除术比前房成形术联合玻璃体抽吸术更有效。玻璃体腔抽吸联合前房成形术手术失败患者的平均年龄为(43.7±4.8)岁,显著低于成功患者的(53.7±12.6)岁(P<0.05)。

结论

恶性青光眼是医源性的,十分之九继发于原发性闭角型青光眼患者的手术。局部应用阿托品是药物治疗的首选。晶状体摘除联合前部玻璃体切除术有更多优势,然而,尤其对于年轻患者不推荐使用。

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