青光眼滤过手术后浅前房的观察及处理

目的探讨青光眼滤过术后浅前房的发生原因及处理方法。方法分析施行穿透性或非穿透性小梁手术的青光眼患者共158例（186眼）的术后情况。结果①术后浅前房：穿透性小梁手术组（93例）32眼，发生率34．41％；非穿透性小梁手术组（93例）3例，发生率为3．23％，两组差异有显著统计学意义（X^2=7．891，P=0．003）；②浅前房的原因：35例浅前房中，脉络膜脱离20眼（占57．14％），引流过畅8眼（22．86％），房水生成不足4眼（11．43％），结膜渗漏2眼（5．71％），恶性青光眼1眼（2．86％）；③浅前房发生的多因素分析表明，与青光眼类型（回归系数β=4．214，P〈0．01）及年龄（p=5．176，P〈0．01）有显著相关性，与性别（β=0．363，P=0．859）无关。结论非穿透小梁切除术可显著降低浅前房的发生率；术者应注意浅前房的易发因素以降低术后浅前房发生率。

Observation and therapy of shallow anterior chamber formed after trabeculectomy in patients with glaucoma

Objective To analyze the cauls for the formation of shallow anterior chamber after trabe-culectomy in patients with glaucoma and its treatment. Methods A total of 186 eyes of 158 subjects with glau-coma who underwent penetrating and non-penetrating trabeculectomy were reviewed retrospectively. Results Shallow anterior chamber occurred in 32 eyes (32/93,34.41%) in penentrating trabeculectomy group,3 eyes (3/93,3. 23%) in non-penetrating trabeculectomy group. Choroidal detachment (20, 57.17%), excessive drainage through filtration track (8,22.86%), low production of aqueous humor (4,11.43%), the leakage of chamber fluid (2,5.71%) and malignant glaucoma (1.2.86%) were the main causes for the development of shallow anterior chamber postoperatively. The correlations between the development of shallow anterior chamber and the type of glaucoma (β=4.214, P<0.001), and age (β=5.176, P<0.001) were statistically signifi-cant. It was not associated with gender (β=0.363, P=0.859). Conclusion Non-penetrating trabeculectomy is a safe technique that significantly reduces the incidence of immediate postoperative shallow anterior chamber. Attention should be paid to the risk factors of the development of shallow anterior chamber postoperatively.