目的:分析青光眼术后迟发性脉络膜上腔出血的危险因素及其预后。方法:对我院自2003-04/2009-12行抗青光眼手术后发生迟发型脉络膜上腔出血的9例患者的临床资料进行整理分析。结果:患者9例9眼术后发生的迟发性脉络膜上腔出血,其中高度近视眼2例,婴幼儿青光眼3例,2例复杂青光眼联合前房人工晶状体取出术,1例无玻璃体眼,另外1例老年患者伴有全身血管性疾病。均于小梁切除术后1~7d发生。早期均药物治疗,1例于出血后11d采用手术处理,成功引流脉络膜上腔积血,余8例出血自行吸收。经平均14mo随访,无眼球萎缩,其中1例视力1.0,3例婴幼儿患者不能配合检查,其余患者术前术后视力无明显变化。4例于1~12mo出现眼压再次升高。结论:术前长时间高眼压、术中眼内压突然下降和持续低眼压、无玻璃体眼、高度近视、复杂青光眼及婴幼儿青光眼等可能为发生迟发性脉络膜上腔出血的危险因素。发生迟发性脉络膜上腔出血后可先给予药物治疗观察,若出血不能吸收,可考虑手术引流脉络膜上腔积血改善预后。

AIM: To analyze the factors and prognosis of delayed choroidal hemorrhage after glaucoma surgery.METHODS: Analysis of the cases of delayed choroidal hemorrhage after glaucoma surgery happened in our hospital during April 2003 to December 2009.RESULTS: There were 9 cases(9 eyes) of delayed suprachoroidal hemorrhage, 2 cases with high myopia, 3 cases with infantile glaucoma, 2 cases with complex glaucoma combined anterior chamber intraocular lens removal surgery, 1 case without vitreous body, another elder case with systemic vascular disease. It was all happened in 1-7 days after trabeculectomy. They were all treated with drug therapy at the early stage, 1 case accepted surgery at postoperative 11 days and the suprachoroidal hemorrhage was successfully drainaged. Other 8 cases with hemorrhage were spontaneously absorbed. After the follow-up of 14 months, no eyeball atrophy was reported and visual acuities were no significant change except 1 case of 1.0, the other 3 cases of infant can''t act in concert with examination. Intraocular pressure increased again in 4 cases at 1-12 month.CONCLUSION:Risk factors for delayed suprachoroidal hemorrhage may include prolonged high intraocular pressure before surgery, intraocular pressure suddenly dropped intraoperatively, sustained low intraocular pressure, eyes with no vitreous body, excessive myopia, complicated glaucoma, infantile glaucoma. Delayed suprachoroidal hemorrhage can firstly treated by medicine. If the hemorrhage still can not be absorbed, surgery of drainaging suprachoroidal hemorrhage can be considered to improve the prognosis.