目的:分析急性闭角型青光眼自然病程,探讨视力下降的影响因素和个性化治疗方案。方法:回顾205例急性闭角型青光眼住院患者的临床资料,对现病史、术前检查、手术治疗时机、手术方案、手术后并发症及处理、出院时视力及影响因素、随访资料进行分析。结果:收集到完整资料205例,药物治疗7例,选择手术治疗198例(96.6%)。198例手术眼中出院时视力下降108例(54.6%),不变42例(21.2%),好转48例(24.2%);7例未手术眼中6例未变,1例好转。并发性白内障101例,虹膜萎缩瞳孔散大固定89例。结论:急性闭角型青光眼是一组相对独立的眼前节症候群。高眼压除对视神经损害外,对角膜、虹膜、晶状体等屈光间质的损害也是造成视力下降的重要原因。急性闭角型青光眼的治疗应针对不同患者、不同分期实施个性化治疗方案。

AIM:To analyze the natural course of acute angle-closure glaucoma and to explore the effect factors of vision and personalized treatment.·METHODS:Clinical data of 205 cases of acute angle-closure glaucoma patients,including current medical history,preoperative examination,timing of surgical treatment,surgical options and post-operative complications of treatment,discharge and impact of visual factors,follow-up data were retrospectively analyzed.·RESULTS:The information collected from 205 cases,with seven cases of drug treatment,198 cases of surgical treatment (96.6%).Of the 198 cases of surgical eyes,vision decreased at discharge in 108 cases (54.6%),remained the same in 42 cases (21.2%),improved in 48 cases (24.2%);7 cases of the eyes without surgery remained unchanged in 6 cases,1 case improved.There were 101 cases of complicated cataract,89 cases of iris atrophy and fixed mydriasis.·CONCLUSION:The acute angle-closure glaucoma is a group of relatively independent anterior segment syndrome,in addition to optic nerve damage,interstitial damage of the high intraocular pressure,such as cornea,iris,and lens,is also an important reason for decreased vision.Acute angle-closure glaucoma treatment should be different for different patients,with the phased implementation of personalized treatment.

R779.6