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恶性青光眼的治疗

Management of Malignant Glaucoma.

作者信息

Sadeghi Reza, Momeni Ali, Fakhraie Ghasem, Eslami Yadollah, Zarei Reza, Vahedian Zakieh, Safizadeh Mona, Tabatabaei Seyed Mehdi

机构信息

Glaucoma Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Curr Ophthalmol. 2023 Apr 29;34(4):389-397. doi: 10.4103/joco.joco_147_22. eCollection 2022 Oct-Dec.

Abstract

PURPOSE

To compare the outcomes of various invasive and noninvasive approaches to the treatment of malignant glaucoma.

METHODS

Glaucoma-related keywords were looked up in PubMed and Google Scholar, and related articles up to 2022 were used to put together this review article.

RESULTS

Numerous surgical methods and techniques have been introduced in the past few years. This review outlined current knowledge regarding the nonsurgical and surgical management of malignant glaucoma. In this regard, we first briefly outlined the clinical presentation, pathophysiology, and diagnosis of this disorder. Then, the current evidence on the management of malignant glaucoma was reviewed. Finally, we discuss the need for treatment of the other eye and the factors that might affect the outcome of surgical intervention.

CONCLUSIONS

Fluid misdirection syndrome, or malignant glaucoma, is a severe disorder that can occur spontaneously due to surgical intervention. The pathophysiology of malignant glaucoma is complicated, and numerous theories exist about the underlying mechanisms that may contribute to the disease. Malignant glaucoma can be treated conservatively using medications, laser therapy, or surgery. Laser treatments and medical treatments have been adequate for the treatment of glaucoma, but the effects have generally been short-lived, and surgical treatment has proved to be the most effective. There have been a variety of surgical methods and techniques introduced. Still, none have been studied in a large proportion of patients as a control case to compare effectiveness, outcomes, and recurrence. Pars plana vitrectomy with irido-zonulo-capsulectomy still seems to have the best results.

摘要

目的

比较各种侵入性和非侵入性治疗恶性青光眼方法的疗效。

方法

在PubMed和谷歌学术中检索青光眼相关关键词,并使用截至2022年的相关文章撰写本综述文章。

结果

在过去几年中引入了许多手术方法和技术。本综述概述了关于恶性青光眼非手术和手术治疗的当前知识。在这方面,我们首先简要概述了该疾病的临床表现、病理生理学和诊断。然后,回顾了关于恶性青光眼治疗的当前证据。最后,我们讨论了对另一只眼进行治疗的必要性以及可能影响手术干预结果的因素。

结论

房水错向综合征,即恶性青光眼,是一种严重的疾病,可因手术干预而自发发生。恶性青光眼的病理生理学很复杂,关于可能导致该疾病的潜在机制存在许多理论。恶性青光眼可以通过药物、激光治疗或手术进行保守治疗。激光治疗和药物治疗对青光眼的治疗已经足够,但效果通常是短暂的,手术治疗已被证明是最有效的。已经引入了多种手术方法和技术。然而,尚未在大部分患者中作为对照病例进行研究以比较有效性、结果和复发情况。玻璃体平坦部玻璃体切除术联合虹膜-悬韧带-晶状体囊切除术似乎仍然具有最佳效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/012b/10170992/eae0435e73b5/JCO-34-389-g001.jpg

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