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目的分析13例20只剥脱综合征眼的青光眼发生情况及其临床特点和治疗效果。方法回顾总结了13例20只剥脱综合征眼的青光眼发生率及其临床特点、治疗方法及疗效。结果13例20只剥脱综合征眼中合并青光眼10例13只,占65%,全部为开角型。眼压15.5～43.38mmHg,平均26.13mmHg。眼底视盘C/D0.3～1.0,其中≥0.6者8眼,占40%,0.8～～1.0者6只眼,占30%。4只眼行单纯超声乳化白内障摘除术后眼压下降。1眼行小梁切除术,术后眼压控制良好。2眼曾行小梁切除术,但术后眼压仍高,视神经进行性损害最终失明。1眼白内障术后眼压仍高,需应用药物。结论剥脱综合征具有较高的青光眼发生率,其眼压难于控制、视野进行性损害迅速、对药物治疗反应差,应及早手术干预。对于处在较早期、较轻微的、视神经尚未严重损害者,单纯超声乳化白内障手术有效,对于已发生严重视神经损害者须行青光眼手术。
Objective To analyze the incidence of glaucoma in 13 eyes of 20 exfoliative syndromes and its clinical features and therapeutic effects. Methods The incidence of glaucoma and its clinical features, treatment and efficacy in 13 eyes of 20 exfoliative syndromes were retrospectively reviewed. Results Thirteen patients (20%) were complicated with glaucoma in 13 eyes, accounting for 65%. All of them were open-angle. Intraocular pressure 15.5 ~ 43.38mmHg, an average of 26.13mmHg. Fundus disc C / D0.3 ~ 1.0, of which ≥ 0.6 were 8 eyes, 40%, 0.8 ~ ~ 1.0 in 6 eyes, accounting for 30%. Four eyes underwent simple phacoemulsification cataract extraction after intraocular pressure decreased. 1 eye trabeculectomy, postoperative intraocular pressure well-controlled. 2 had trabeculectomy, but postoperative IOP is still high, progressive damage to the optic nerve eventually blindness. 1 intraocular pressure after cataract surgery is still high, the need for the application of drugs. Conclusion The exfoliation syndrome has a higher incidence of glaucoma, its intraocular pressure is difficult to control, rapid visual field damage, poor response to drug treatment, surgical intervention should be as early as possible. In the earlier, minor, optic nerve has not yet seriously damaged, simple phacoemulsification cataract surgery is effective, for severe retinal damage who have undergone glaucoma surgery.