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目的 讨论青光眼滤过术后浅前房形成的常见原因及处理方法。方法 回顾性总结北京同仁医院青光眼组 1998年 10月～ 1999年 10月期间连续收治的 3 5 2例青光眼住院患者行青光眼滤过性手术后发生浅前房的原因、类型及处理方法。结果 共行青光眼滤过性手术 495只眼 ,其中 117只眼发生浅前房 ,发生率为 2 3 64 %。小梁切除术为 19 2 % ( 15 /78) ,小梁切除术 +MMC为 3 2 %( 93 /2 91) ,青光眼联合白内障的三联手术为 7 1% ( 9/2 6)。浅前房发生在术后 1～ 7天 ,其中滤过过畅 3 6只眼 ( 3 0 77% )、睫状体脉络膜脱离 3 4只眼 ( 2 9 0 6% )、结膜瓣渗漏 2 7只眼 ( 2 3 0 8% )、恶性青光眼 15只眼 ( 12 8% )、恶性青光眼合并睫状体脉络膜脱离 3只眼 ( 2 5 6% )、脉络膜上腔出血 2只眼 ( 1 71% )。需要手术治疗的 3 5只眼 ,其余 82只眼仅通过保守治疗均能恢复前房。结论 青光眼滤过术后浅前房发生率较高 ,其常见原因是房水滤过过畅、结膜瓣渗漏及睫状体脉络膜脱离。以小梁切除术 +MMC的发生率最高 ,MMC不但能阻止滤过泡的纤维化 ,而且能使房水分泌减少。大多数浅前房可通过保守治疗治愈。
Objective To discuss the common causes and treatment of shallow anterior chamber after glaucoma filtration surgery. Methods The causes, types and treatment methods of shallow anterior chamber after glaucoma filtration surgery were retrospectively reviewed in 325 cases of glaucoma hospitalized in Beijing Tongren Hospital Glaucoma Group from October 1998 to October 1999. Results A total of 495 eyes underwent glaucoma filtration surgery, of which 117 eyes had a shallow anterior chamber, the incidence was 23 64%. Trabeculectomy was 19.2% (15/78), trabeculectomy + MMC was 32% (93/291), glaucoma combined with cataract surgery was 7 1% (9/2 6). Shallow anterior chamber occurred 1 to 7 days after operation, of which 36 were filtered (30 77%), 34 (296%) were ciliary choroidal detachment, 2 7 eyes (23.0%), 15 eyes of malignant glaucoma (12.8%), 3 eyes of malignant glaucoma with ciliary choroidal detachment (2.56%), 2 eyes of choroidal hemorrhage %). 35 need surgery, and the remaining 82 eyes can recover anterior chamber only through conservative treatment. Conclusion The incidence of shallow anterior chamber after glaucoma filtration surgery is relatively high. The common causes are filtration of aqueous humor, conjunctival valve leakage and ciliary body choroidal detachment. Trabeculectomy with the highest incidence of MMC, MMC can not only prevent filtration bleb fibrosis, but also to reduce aqueous humor secretion. Most shallow anterior chamber can be cured by conservative treatment.