目的:探讨急性闭角型青光眼高眼压持续状态下行前房穿刺的疗效、必要性、可行性。方法:将药物治疗后仍处于高眼压持续状态(眼压>40mmHg)的急性闭角型青光眼病例随机分为两组,A组(治疗组)术前2d行前房穿刺,将眼压降至正常范围后行小梁切除术;B组(对照组)在高眼压状态下行小梁切除术。对两组术后滤过泡、眼压、视力、手术成功率和并发症进行比较。结果:前房穿刺未发生严重并发症,穿刺后眼压随即下降。A组术后前房炎症反应眼数及程度明显低于B组(P<0.01);功能性滤过泡形成率、手术成功率、眼压控制情况及视力恢复情况明显优于B组(均P<0.05)。结论:前房穿刺是治疗急性闭角型青光眼高眼压持续状态的辅助措施,能缩短降眼压时间,减轻因高眼压造成的视功能损害,提高手术成功率,降低手术并发症。

AIM:To evaluate the necessity,feasibility and effects of paracentesis of anterior chamber for acute angle-closure glaucoma with consistent high intraocular pressure(IOP).METHODS:The patients whose high IOP>40mmHg couldn’t be effectively reduced by drug treatment were randomly divided into 2 groups(group A and group B).Paracentesis of anterior chamber was performed on group A(treatment group) before operation,then performed tarbeculectomy after IOP returned to normal.And trabeculectomy was performed on group B(control group) under high IOP.The IOP,functional filter blebs,visual acuity,success rate of operation and complications of both groups were compared.RESULTS:No serious complications were found in group A.The IOP was decreased after paracentesis of anterior chamber.The eyes number and level of anterior chamber inflammation after operation in group A was slighter than that in group B(P<0.01).The rate of functional filter blebs formed,the success rate of operation,and the rate of visual recovery in group A were better than those in group B.The difference was significant(P<0.05,P<0.05,P<0.05,P<0.05).CONCLUSION:Paracentesis of anterior chamber as the auxiliary treatment of acute anger-closure glaucoma could shorten the time of reducing IOP,lessen visual function damage by high IOP,improve the success rate of operation,and reduce surgical complications.

R779.6