前房穿刺术在急性闭角型青光眼高眼压持续状态下临床应用_黄河.pdfVIP

·18· 实用防盲技术2014年2月第9卷第1期 ·临床研究· 前房穿刺术在急性闭角型青光眼 高眼压持续状态下临床应用 黄河 孙翼虎 吴厦华 吴忠 【摘要】 目的 分析前房穿刺术在急性闭角型青光眼急性发作期药物不能控制眼压中的疗效及其并发症情况。方法 对 21例22眼急性闭角型青光眼急性发作患者在应用常规降眼压药物治疗未能有效降压后，采取表麻下手术，显微镜下进行前 房穿刺术放液，观察眼压控制以及并发症情况。结果 术前眼压均≥50mmHg ，所有患者经穿刺放液后，症状缓解，眼压下 降，平均为21.5mmHg ，视力提高，角膜水肿及睫状充血明显好转，8例患眼术后次日复查眼压复上升，于原穿刺切口再放 液，眼压控制后予以相应手术，术后恢复良好。结论 前房穿刺术是治疗急性闭角型青光眼急性发作期高眼压持续状态的有 效方法，损伤小，反应轻，并发症少，为急性闭角型青光眼进一步治疗创造了条件，并且能够改善其预后。 【关键词】前房穿刺术； 急性闭角型青光眼； 高眼压 Doi:10.3969/j.issn.1673-3835.2014.01.008 The clinical application of anterior chamber paracentesis in aute angle-closure glaucoma patients with sustained high intraocular pressure 【Abstract】 Objetive To analyze the efficacy and complications of anterior chamber paracentesis in patients with acute angle- closure glaucoma who could not control intraocular pressure (IOP) with conventional drugs. Methods
22 eyes of 21 patients with acute angle-closure glaucoma who failed to control IOP with conventional drugs underwent anterior chamber paracentesis under topic anesthesia. The IOP and complications were observed. Results
The preoperative intraocular pressure was more than 50mmHg in all patients. And after paracentesis , IOP decreased to an average of 21.5mmHg, symptoms alleviated, visual acuity improved, corneal edema and ciliary congestion significantly relived. 8 cases undergoing surgery suffer from IOP rise in the next day, after undergoing paracentesis again, the IOPs were controlled.
Conclusion
anterior chamber paracentesis is effective, safe, with little complications in treating acute angle-closure glaucoma with continuous high IOP. It could make preparation for subsequent therapy. 【Key words 】 Paracentesis of anterior chamber; Aute angle-closure glaucoma; Ocular hypertension 青光眼是继白内障之后全球第二大致盲性眼