摘要
目的:探究晶状体悬韧带松弛或不全脱位继发青光眼的临床特点,分析手术对视力、眼压等的影响。方法:回顾性分析2014-12/2016-12于我院眼科治疗的晶状体悬韧带松弛或不全脱位继发青光眼患者38例38眼的临床资料,观察临床特点,术前检查并根据悬韧带的部位和晶状体脱位范围选择手术方式,分析手术前后前房深度、角膜内皮细胞密度、眼压、视力及术后并发症情况。结果:术后10d患者平均眼压(18.17±1.43mmHg)较手术前(38.77±2.45mmHg)显著降低,差异具有统计学意义(P<0.05)。术后3d,25眼眼压恢复正常(≤21mmHg);术后10d,34眼眼压恢复正常,其余4眼再次行青光眼引流阀植入术后眼压恢复正常。术前视力0.1～<0.2、0.2～<0.5、≥0.5分别为5、17、16眼,术后6mo分别为2、17、19眼,手术前后视力比较,差异无统计学意义(P>0.05)。术后前房深度(2.45±0.44mm)较术前(1.23±0.35mm)显著升高,差异具有统计学意义(P<0.05)。术后角膜内皮细胞密度为(878.34±322.12个/mm^2)较术前(1735.32±340.32个/mm^2)显著降低,差异具有统计学意义(P<0.05)。术后3d,出现角膜水肿8眼,虹膜术后粘连或不同程度的萎缩4眼,前房积血3眼,瞳孔少许渗出2眼。结论:晶状体悬韧带松弛或不全脱位继发青光眼临床症状、体征较为复杂,临床上需要与其它类型青光眼进行辨别。
AIM:To investigate the clinical characteristics of secondary glaucoma caused by lens suspensory ligament laxity or occult subluxation,and to analyze the influence of operation on visual acuity and intraocular pressure(IOP).METHODS:Totally 38 cases(38 eyes)of the secondary glaucoma caused by lens suspensory ligament laxity or occult subluxation in ophthalmology department of our hospital from December 2014 to December 2016 were enrolled and their medical records were analyzed retrospectively to observe the clinical characteristics of glaucoma.Preoperative mydriasis was carried out and surgical methods were chosen according to the lenses location and extent of suspensory ligament.Preoperative and postoperative anterior chamber depth,corneal endothelial cell density,IOP,visual field,visual acuity and complications were analyzed.RESULTS:The average intraocular pressure was 18.17~1.43mmHg at postoperatively 10d,which was significantly lower than 38.77~2.45mmHg before operation,the difference had statistical significance(P<0.05).The IOP of 25 eyes returned to normal(≤21mmHg)at 3d after surgery.The IOP of 34 eyes with the usage of IOP lowering medication returned to normal at postoperative 10d.The IOP of 4 eyes came to normal after undergoing glaucoma drainage valve implantation again.There were 5 eyes with visual acuity ranged 0.1 to<0.2,17 eyes 0.2 to<0.5,16 eyes≥0.5 preoperatively,and 2 eyes,17 eyes and 19 eyes postoperatively,the difference was not significant(P>0.05).The postoperative anterior chamber depth was 2.45~0.44mm,which was significantly higher than 1.23~0.35mm before operation,the difference had statistical significance(P<0.05).The postoperative corneal endothelial cell density was 878.34~322.12/mm2 and decreased significantly,compared with 1735.32~340.32/mm2 before operation,the difference had statistical significance(P<0.05).There were 8 eyes with corneal edema,4 eyes with iris adhesion or varying degrees of atrophy,3 eyes with anterior chamber hemorrhage,and 2 eyes with pupil exudate at 3d after surgery.CONCLUSION:Clinical symptoms and signs of secondary glaucoma in patients with lens suspensory ligament laxity or occult subluxation are more complex,which needs to be distinguished with other types of glaucoma in clinical treatment,and its surgical methods shall be chosen according to different suspensory ligament site and lens subluxation scope.
作者
马伊
Yi Ma(Department of Ophthalmology,Tianjin People's Hospital,Tianjin 300121,China)
出处
《国际眼科杂志》
CAS
北大核心
2018年第4期723-725,共3页
International Eye Science
关键词
晶状体悬韧带松弛
晶状体不全脱位
继发青光眼
临床特点
手术方法
lens suspensory ligament laxity
occult subluxation
secondary glaucoma
clinical features
surgical methods
作者简介
马伊,毕业于天津医科大学,本科,副主任医师,眼科主任,研究方向:白内障、青光眼。通讯作者:马伊.mayi1962@163.com
