加强对真性小眼球继发青光眼治疗的认识.pdfVIP

《眼科》2007 年第16 卷第1 期 Ophthalmol CHN, 2007, Vol. 16 No. 1 ·述评· 加强对真性小眼球继发青光眼治疗的认识 张舒心 作者单位：100730 首都医科大学附属北京同仁医院 北京同仁眼科中心 （Email: zsx@public3.bta.net.cn ） 【摘要】真性小眼球继发青光眼施行滤过手术而失明者并不罕见，尤其是在手术虽比较普及但手术水 平参差不齐的情况下。闭角型青光眼在手术前必须注意眼轴长短，以了解是否存在真性小眼球。简单的三 步判断法可对之进行筛选。对真性小眼球继发青光眼的治疗要注重总体设计。选择用药时应慎用缩瞳剂。 手术治疗须充分考虑到术后严重并发症如恶性青光眼、葡萄膜渗漏、脉络膜脱离、驱逐性出血等的高风险 性，采用的术式应根据其发病机理及患者眼部结构的不同而设计。术前与患者及家属密切沟通及手术医师 的精湛技巧是保证手术成功的重要因素。（眼科, 2007, 16: 6-8 ） 【关键词】真性小眼球；继发性青光眼/外科学 To enhance the understanding of treatment for nanophthalmos secondary glaucoma ZHANG Shu-xin. Beijing Tongren Eye Center, Affiliated Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Corresponding author: ZHANG Shu-xin, Email: zsx@public3.bta.net.cn 【Abstract 】It is not rare for nanophthalmos secondary glaucoma that filtration operation results in blindness, especially after the filtration operation is more popular, but surgical skill is not enough even for every surgeon. Thus the eye axis measurement is emphasized for patients with angle closure glaucoma in order to affirm whether it is nanophthalmos, and a simple three-step method is introduced to recognize nanophthalmos quickly. We should stress the general detail design for treatment of nanophthalmos secondary glaucoma. It should be careful to use miotic agents during its treatment. If have to do surgeries, we should know their high risk s and can correctly deal with complications such as malignant glaucoma, uveal effusion, choroid detachment, expulsive hemorrhage and so on. Its surgical fashions will depend on pathophysiological mechanisms and structure of ocular anterior segment of patients with nanophthalmos. Good communications with patients and their relatives and excellent operative skills are important factors for ensuring successful surgeries. (Ophthalmol CHN, 2007, 16: 6-8) 【Key words 】nanophthalmos; secondary glaucoma/