关键词: 原发性闭角型青光眼, 恶性青光眼/外科学

Abstract:  Objective To investigate the efficacy of different surgical treatments for malignant glaucoma. Design Retrospective case series. Participants 31 malignant glaucoma patients (34 eyes) admitted in Wuhan Aier Eye Hospital in 2009-2011. Methods Disease characteristics, treatment methods and results of all patients were reviewed. The mean follow-up time was 21.7 ± 6.5 months. Main Outcome Measures  corrected visual acuity, intraocular pressure, anterior chamber depth and complications. Results Over the 34 eyes,  malignant glaucoma occurred after trabeculectomy in 28 eyes (82.4%), during trabeculectomy in 4 eyes (11.8%), after combined cataract extraction with trabeculectomy in 2 eyes (5.9%). Four eyes (11.8%) were well controlled with atropine. Nd-YAG laser capsulotomy and disruption of anterior hyaloid face were performed in 2 eyes (5.9%), vitrectomy combined with anterior chamber reconstruction in 12 eyes (35.3%), cataract extraction and intraocular lens implantation in 8 eyes (23.5%), and combined cataract extraction with vitrectomy in 8 eyes (23.5%). Recurrent malignant glaucoma 1 month after treatments was observed in 3 eyes. Intraocular pressure before and after treatment was 42.5±11.8, 15.3±4.2 mm Hg, respectively (P=0.000). Anterior chamber depth before and after treatment was 0.3±0.4, 2.4±0.4 mm, respectively (P=0.000). Eighteen eyes with counting finger or more of corrected visual acuity before treatment became 0.1-0.3 in 7 eyes, and 0.3 or more in 6 eyes after treatment. Vitreous hemorrhage, corneal endothelial decompensation and topical atropine allergy appeared respectivel each in 1 eye. Conclusions Malignant glaucoma usually needs lens-vitreous surgery. Timely surgical treatments based on specific circumstances of patients may archive better vision effect. (Ophthalmol CHN, 2013, 22: 38-41)

Key words: primary closed-angle glaucoma, malignant glaucoma/surgery