玻璃体切割联合超声粉碎、小梁切除治疗晶体全脱位性青光眼_0.docVIP

玻璃体切割联合超声粉碎、小梁切除治疗晶体全脱位性青光眼 作者：杨安怀，周治民，梅海峰，艾明 【关键词】 玻璃体切割；超声粉碎；小梁切除 　　［摘要］ 目的 评价玻璃体切割联合超声粉碎、小梁切除 治疗 晶体全脱位性青光眼的疗效。 方法 共收入9例9眼外伤性晶体全脱位性青光眼，这些病例都有共同的特点：（1）晶体全脱位于玻璃体腔；（2）瞳孔散大，前房消失；（3）眼压40mmHg以上，药物治疗无效。先用玻璃体切割器切除玻璃体后，再用超声粉碎器将晶体吸引至玻璃体腔中央行超声粉碎术，术毕做常规小梁切除术。结果 术后视力较术前均有不同程度提高。术前所有患者视力均在光感至手动范围，其中提高到指数有2眼，0.1~0.3者有3眼，0.3以上者有4眼。术后所有病例眼压均恢复正常或略偏高，15~20mmHg者5眼，20~24mmHg有4眼，经点滴降眼压药物后，眼压降至20mmHg以下。结论 玻璃体切割联合超声粉碎、小梁切除治疗晶体全脱位性青光眼，具有眼内组织损伤小，术后散光轻及并发症少等优点。 　　［关键词］ 玻璃体切割；超声粉碎；小梁切除 　　Vitrectomy combined with phacofragmentation and trabeculectomy for glaucoma due to complete luxation of lens 　　［Abstract］ Objective To evaluate the clinical therapeutic effects of vitrectomy combined with phacofragmentation and trabeculectomy for glaucoma due to complete luxation of lens.Methods Vitrectomy was performed in 9 patients with traumatic glaucoma due to complete luxation of lens at first,then phacofragmented the lens in the middle of Vitreous cavity,At last trabeculectomy was followed. The re were the common characters in these patients:（1）Lens dislocation in vitreous cavity.（2）Dilalation of pupil and flat anterior chamber.（3）Intraocular pressures （IOP） were above 40 mmHg and drugs treatment were effectless.Results The postoperative visual acuity had improved in various degrees in all cases.The peroperative visual acuity were between light perceptions （LP） to hand movements （HM）,while the postoperative visual acuity recovered to counting fingers （CF） in 2 eyes,0.1~0.3 in 3 eyes,0.3 in 4 eyes.The postoperative IOP were 15~20 mmHg in 5 eyes,20~24 mmHg in 4 eyes and decreased below 20 mmHg following treatment of eyes drops obtained.Conclusion Vitrectomy combined with phacofragmentation and trabeculotomy for glaucoma due to complete luxation of lens has the advantages of little injurys in ocular tissues,light astigmatism and few postoperative complications. 　　［Key words］ vitrectomy;phacofragmentation;trabeculectomy 钝伤导致的晶体全脱位除引起视力障碍和部分视野遮挡外，最常见的并发症是青光眼，最有效的治疗方式是手术治疗。近年随着玻璃体切割器及超声粉碎的 发展 和 应用 ，极大