硅油入前房继发青光眼的临床治疗作者:袁容娣,贺翔鸽,刘少章,王维光单位:第三军医大学大坪医院野战外科研究所眼科,垂庆400042提要:目的探讨硅油入前厉继发青光眼的临床治疗方法。方法硅油入前厉继发青光眼26例,其中无品体眼22例,有品体眼4例。硅油填充3个月以上,网膜复位好的患者直接取出硅油。无晶体眼患者分别行俯卧位、激光或手术行下方蛀膜周切、硅汕再注入、角膜下方小梁切除术。有晶体眼患者使用Healon将硅汕从前房排出,硅汕再入前房者切除晶体、硅汕再注入、6点周边蛀膜切除。患者眼压控制后随访3个月眼压。结杲除1例无晶体眼患者放弃治疗外,其余患者随访3个月眼压控制。21例无晶体眼患者经不同方法治疗,眼压得到控制,其中5例单纯釆用俯卧位、5例激光虹膜周切、4例手术虹膜周切、2例硅油再注入、2例直接取油、3例行角膜卜方小梁切除术。有晶体眼患者4眼眼压均控制,其中3例使川Healon将硅汕从前厉排出,1例切除品体、硅油再注入。结论硅油入前厉继发青光眼经多种方法治疗后可获得满意疗效。关键词:继发性青光眼;硅油;临床治疗中图法分类号:R775;R779.6;R916.3文献标识码:AClinicaltreatmentforsecondaryglaucomaduetosiliconeoilmigratingintoanteriorchamberYUANRong-di,HEXiang-ge,LIUShao-zhang,WANGWei-guang(DepartmentofOphthalmology,DapingHospital,ThirdMilitaryMedicalUniversity,Chongqing400042,China)Abstract:ObjectiveToexploretheclinicaltherapeuticmethodsforsecondaryglaucomainducedbythemigrationofsiliconeoilintotheanteriorchamber.MethodsTotally26casesofsuchsecondaryglaucomajncluding22aphakiceyesand4phakiceyesweresubjected.Siliconeoilwasdirectlytakenoutforthepatientswhoseretinawasrepositedwellaftersiliconeoilinjectionforover3months.Theaphakicpatientsunderwentbo’clockpositionperipheraliridectomywithlaseroroperationonproneposition,thensiliconoilwasreinjected,andtrabeculectomywascarriedoutthroughinferiorcornea.ThephakicpatientsreceivedsiliconeoilaspirationwithHealonfromtheanteriorchambe匚Whensiliconeoilremigratedintotheanteriorchamber,thecrystalwasresected,siliconeoilwasreinjected,and6o’clockpositionperipheraliridectomywereperformed.Thepatientswerefollowedupfor3monthsaftertheintraocularpressure(IOP)reachingnormalrange.ResultsExceptonepatientgaveuptreatment,allthepatientshadstableandnormalIOPafter3monthsoffollow-up・IOPwasconUolledthroughdifferentmethodsin21aphakiceyes:5withproneposition,5with6’clockpositionperiph-eraliridectomythroughlaseroroperation,4withsiliconoilreinjecting,2withirectaspirationofsiliconeoil,and3withtrabeculectomyundercornea・IOPwascontroledinallofphakiceyes:3withHealonaspirationofsiliconeoil」withcrystalresectionandreinjectionofsiliconeoi.lConclusionSecondaryglaucomainducedbymigrationofsiliconeoilintotheanteriorchambercanbesatisfactorilytreatedbymanyways.Keywords:secondaryglaucoma;siliconeoil;clinicaltreatment玻璃体切割、硅汕填充术后继发青光眼是常见并发症。其中硅汕入前房继发青光眼的眼压治疗困难,仅有60%的眼压可得到控制[1],处理不好可使视力丧失、玻璃体手术失败。木科于2000年1月至2007年1月收治26例硅油入前房继发青光眼患者,现报告如下。1对彖与方法1.1病例情况患者26例,男性16例,女性10例,年龄18~62岁,平均42岁。所有患者均为复杂性视网膜脱离行玻璃体切割加硅油填充术,其中8例患者同时行巩膜外环扎术。硅油填充时间为7d至3年。26例患者中17例为原发性孔源性视网膜脱离,5例为外伤继发性视网膜脱离,3例糖尿病增殖性视网膜病变,1例视网膜静脉周用炎玻璃体积血继发性视网膜脱离,糖尿病及视网膜静脉周围炎患者术中行全视网膜光凝。26例患者中无晶体眼22例(均为囊膜缺如或不全,其中3眼伴复发性牵引性视网膜脱离,因脱离时间长,放弃网膜复位术),有晶体眼4...