无晶状体眼和人工晶状体眼慢性青光眼的手术治疗

Surgical therapy of chronic glaucoma in aphakia and pseudophakia.

作者信息

Gross R L, Feldman R M, Spaeth G L, Steinmann W C, Spiegel D, Katz L J, Wilson R P, Varma R, Moster M R, Marks S

机构信息

William A. and Anna V. Goldberg Research Laboratories, Wills Eye Hospital, Philadelphia.

出版信息

Ophthalmology. 1988 Sep;95(9):1195-201. doi: 10.1016/s0161-6420(88)33027-7.

DOI:10.1016/s0161-6420(88)33027-7

PMID:3211498

Abstract

Most glaucoma surgical procedures are less successful in aphakic or pseudophakic eyes. The authors reviewed 91 consecutive initial glaucoma procedures in aphakic patients from 1979 to 1986 to determine successful outcomes and complications. Success was defined as an intraocular pressure (IOP) of at least 30% below the preoperative value and less than 21 mmHg, less than 2 lines of Snellen acuity loss, and no further surgical intervention. At 9 months, success rates were: trabeculectomy, 4 of 15 patients; cyclodialysis, 3 of 20 patients; neodymium:YAG (Nd:YAG) cyclophotocoagulation, 1 of 8 patients; cyclocryotherapy, 9 of 22 patients; anterior chamber tube shunt (Schocket procedure), 3 of 6 patients; and argon laser trabeculoplasty, 2 of 20 patients. Severe complications included phthisis bulbi in 11% of cyclocryotherapy and severe visual loss in 20% with cyclodialysis and 14% with cyclocryotherapy. Results confirm the difficulty of surgical therapy in these patients.

摘要

大多数青光眼手术在无晶状体眼或人工晶状体眼中的成功率较低。作者回顾了1979年至1986年间连续91例无晶状体患者的初次青光眼手术，以确定手术的成功结果和并发症。成功的定义为眼压（IOP）至少比术前值低30%且低于21 mmHg，斯内伦视力损失少于2行，并且无需进一步手术干预。在9个月时，成功率如下：小梁切除术，15例患者中有4例成功；睫状体分离术，20例患者中有3例成功；钕：钇铝石榴石（Nd：YAG）睫状体光凝术，8例患者中有1例成功；睫状体冷凝术，22例患者中有9例成功；前房引流管分流术（肖克特手术），6例患者中有3例成功；氩激光小梁成形术，20例患者中有2例成功。严重并发症包括睫状体冷凝术患者中有11%发生眼球痨，睫状体分离术患者中有20%以及睫状体冷凝术患者中有14%发生严重视力丧失。结果证实了这些患者手术治疗的困难。