恶性青光眼的临床分析-眼科学专业论文.docxVIP

恶性青光眼的临床分析 硕士研究生：曾瑾 导 师：朱益华 副教授 摘 要 目的 通过对恶性青光眼病例的分析，总结其发病率、发生规律及治疗经验，从而 更好的指导临床诊断及治疗。 方法 回顾性总结 2005 年 1 月~2009 年 12 月福建医科大学附属第一医院眼科住院 病人，重点查阅了青光眼手术病人特别是恶性青光眼的临床资料，对恶性青光眼的发病 率、临床类型、治疗方法及预后等进行分析总结。 结果 1、2005 年 1 月~2009 年 12 月住院治疗各种类型青光眼患者 1024 例，其中闭 角型青光眼 892 例，接受手术治疗的有 778 例；施青光眼滤过手术有 936 只眼。其间共 发生恶性青光眼 12 例(14 眼)，9 例（11 眼）发生于青光眼滤过性手术后，1 例(1 眼)发 生在白内障超声乳化联合人工晶体植入术后，1 例(1 眼)发生在视网膜脱离复位手术后， 1 例(1 眼)发生在青光眼白内障联合手术及人工晶体植入术后。2、12 例（14 眼）恶性青 光眼患者除 1 例拒绝手术自动出院外，其他 11 例（13 眼）接受玻璃体抽吸加前房重建 手术或白内障摘除加人工晶体植入术，其中 9 例（10 眼）术后前房恢复、眼压降至正常； 1 例（2 眼）前房恢复正常但眼压较高，长期局部点药眼压控制良好；1 例（1 眼）术后 前房及眼压均未恢复正常，后行人工晶体取出加前部玻璃体切割术，术后眼压及前房恢 复正常。 结论 1、 恶性青光眼约 占闭角型青光眼施行任何手术后的 1.16%(9/778)。2、 恶性青光眼绝大部分为典型性恶性青光眼。3、大部分恶性青光眼可以通过玻璃体抽吸 加前房重建术或白内障摘除加人工晶体植入术这样的常规手术恢复正常，个别病例需通 过前部玻璃体切割等手术恢复前房和眼压。 关键词 恶性青光眼；病因；手术治疗 Clinical Analysis of Malignant Glaucoma Postgraduate: Zengjin Tutor: Zhu Yi-hua Prof. ABSTRACT Objective To summarize the incidence, occurred regularity and treated experience by analyzing the cases of malignant glaucoma, thus so as to guide clinical diagnosis and treatment. Methods From January 2005 to December 2009, hospitalized patients in the department of ophthalmology were summarized retrospectively in The First Affiliated Hospital of Fujian Medical University. Cases of glaucoma underwent surgical treatment were investigated emphatically and cases of malignant glaucoma were readed especially. Incidence, clinical category, treatment methods, prognosis of malignant glaucoma were analyzed and summarized. Results 1. There are 1024 all kinds hospitalized cases of glaucoma from January 2005 to December 2009, 892 cases are angle-closure glaucoma, 778 cases were operated, of the total; 936 eyes are operated by filtering procedure. 12 cases (14 eyes) of malignant glaucoma of these cases generated malignant glaucoma. 9 cases (11 eyes) occurred after trabeculectomy of glaucoma, 1 case (1 eye) resulted from other phacoemulsification and IOL implantation, retinal detachment surgery resulted