摘要
目的探讨前房穿刺放液在处理急性闭角型青光眼急性发作期药物不能控制的高眼压持续状态中的疗效及并发症发生情况。方法对50例54只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低眼压后，采用26GB—D注射针头在手术显微镜下进行前房穿刺放液，观察眼压控制以及并发症发生情况。结果术前眼压均〉50mmHg。所有患者经穿刺放液后高眼压及眼痛症状迅速缓解，眼压平均为22mmHg。视力均有不同程度的提高。11只眼穿刺后约2-3h眼压再次升高，遂再次放液。术后20只眼有轻微前房炎性渗出，5只眼有轻度前房出血，4只眼角膜水肿较术前加重，5只眼检查发现轻度视网膜出血。眼压控制后给予相应的手术治疗，术后恢复良好。结论前房穿刺放液损伤小，反应轻，严重并发症发生率低，是治疗急性闭角型青光眼急性发作期药物不能控制高眼压持续状态的重要辅助措施，为青光眼的进一步治疗创造了条件，并且能够改善预后。
Objective To evaluate the efficacy and complications of paracentesis of anterior chamber to treat acute angle-closure glaucoma which couldn＇t controlled by drugs and with persistent ocular hypertension. Methods Fifty patients （54 eyes） with acute angle-closure glaucoma were received puncture of anterior chamber with a 26G BD under a microscope when the medicine therapy couldn＇t lower intraocular pressure. Observe the lOP and complications. Results The mean preoperative in- traocular pressure was over 50 mmHg. All patients＇ high intraocular pressure and eye pain were relief immediately after the puncture of anterior chamber. The average intraocular pressure was 22 mmHg. Vision improved to varying degrees, of which 9 eyes reached 0.3 or more, 25 eyes reached 0.1-0.3, 20 eyes＇ vision was counting fingers-〈0.1, 11 eyes had intraocular pressure high again and had retreatment. Twenty eyes had mild anterior chamber inflammatory exudation, 5 eyes had mild hyphema, 4 cases had corneal edema, 5 cases had mild retinal hemorrhage. Conclusions Puncture of anterior chamber can lower the IOP immediately and has little damage and complication. It is an important ongoing adjuvant treatment, which can reduce the patient＇s suffering by lowering the IOP quickly, reduce the damage of visual function caused by long-term higher intraocular pressure, avoid side effect of the drugs, and can improve the prognosis.
出处
《中国实用眼科杂志》
CSCD
北大核心
2011年第11期1176-1178,共3页
Chinese Journal of Practical Ophthalmology
关键词
青光眼
高眼压
前房穿刺
Glaucoma
Ocular hypertension
Paracentesis of anterior chamber
