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目的观察高眼压状态下抗青光眼手术的疗效。方法对20例持续高眼压性青光眼患者,先行前房穿刺缓慢放出房水后,再行复合小梁切除术,术后观察滤过泡、前房及眼压、视力变化情况。结果术后1年眼压控制≤21mm Hg(1mm Hg=0.133kPa)者17例,占85%,需局部用药方可控制者3例,占15%,术后出院时视力提高或保持不变者20例,占100%。术后发生瞳孔区渗出2例,浅前房3例,前房出血1例,未见脉络膜上腔出血等严重并发症的发生。结论高眼压状态下前房穿刺后再行复合小梁切除术,可有效控制眼压,保持或改善视力,是持续高眼压性青光眼治疗的有效术式之一。
Objective To observe the effect of anti-glaucoma surgery under high intraocular pressure. Methods Twenty patients with continuous high intraocular pressure glaucoma were treated with compound trabeculectomy after premature anterior chamber puncture. After operation, the changes of filtration bleb, anterior chamber and intraocular pressure and visual acuity were observed. Results One year after operation, intraocular pressure (IOP) ≤21mm Hg (1mm Hg = 0.133kPa) was 17% (85%). Only three patients (15%) needed topical administration, and their visual acuity improved or remained unchanged 20 cases, accounting for 100%. Postoperative pupil zone exudation in 2 cases, 3 cases of shallow anterior chamber, 1 case of anterior chamber hemorrhage, no serious complications such as choroidal hemorrhage occurred. Conclusions Combined trabeculectomy with anterior chamber puncture under high intraocular pressure (IOP) can effectively control intraocular pressure and maintain or improve visual acuity. It is one of the effective procedures for the treatment of continuous intraocular pressure glaucoma.