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目的:探讨原发性慢性闭角型青光眼年轻患者临床治疗的经验和体会。方法:对2000-01/2005-12中山眼科中心临床收治的38例50眼、年龄<40岁、临床确诊为进展期或晚期原发性慢性闭角型青光眼的患者、进行抗青光眼手术处理的病例进行回顾性分析。随访时间平均(23.6±7.5)mo;所有的病例都有完善的眼科检查。临床结果评价包括临床特点、手术结果和并发症。结果:患者平均年龄为(33.5±6.1岁;女性占60.5%;眼轴长平均(22.4±3.5)mm,其中短眼轴占18.0%,小眼球占14%;有60%的患者为浅前房(<1.9mm);超声生物显微镜检查高褶虹膜构型占80.6%,手术前后眼压差异有统计学意义(P<0.001)。4眼因眼压控制不理想,行二次抗青光眼手术治疗。术后并发症主要有浅前房(20%),恶性青光眼(12%)。结论:对进展期或晚期的年轻原发性慢性闭角型青光眼患者进行复合式小梁手术治疗是行之有效的手段,但术后容易出现浅前房、恶性青光眼。术前详细检查、手术操作精细以及有效处理术后并发症将有助于提高手术成功率和减少并发症。
Objective: To investigate the clinical experience and experience of young patients with primary chronic angle-closure glaucoma. Methods: 38 cases (50 eyes) of Zhongshan Ophthalmic Center from January 2000 to December 2005 were enrolled in this study. They were under 40 years of age and clinically diagnosed as advanced or late primary chronic angle-closure glaucoma. The patients were treated with anti-glaucoma surgery The cases were retrospectively analyzed. Follow-up time was (23.6 ± 7.5) mo on average; all cases had a complete eye examination. Clinical outcome evaluations include clinical characteristics, surgical outcomes, and complications. Results: The average age of the patients was (33.5 ± 6.1) years old; female was 60.5%; axial length was (22.4 ± 3.5) mm, short axis was 18.0%, small eye was 14%; and 60% Room (<1.9mm); ultrasound biomicroscopy examination of iris configuration accounted for 80.6%, intraocular pressure before and after surgery there was significant difference (P <0.001) .4 due to intraocular pressure control is not ideal, the line of anti-glaucoma surgery (20%) and malignant glaucoma (12%) .Conclusions: The treatment of advanced trabecular surgery combined with trabeculectomy in advanced or late-stage patients with chronic angle-closure glaucoma The effective means, but postoperative prone to shallow anterior chamber, malignant glaucoma.Preoperative detailed examination, fine operation and surgical treatment of postoperative complications will help to improve the success rate of surgery and reduce complications.