青年原发性闭角型青光眼的临床特征

目的分析青年原发性闭角型青光眼患者的临床特点及治疗效果。方法回顾性分析2009年6月至2019年6月山西省眼科医院17~40岁青年原发性闭角型青光眼51例(61眼)的病历资料,随访时间为6个月至2年。结果本研究中男15例(29.41%),女36例(70.59%),男女比例为1∶2.4。包括急性闭角型青光眼21眼(34.43%),慢性闭角型青光眼40眼(65.57%)。急性闭角型青光眼患者术后的视力较慢性闭角性青光眼提高且眼压控制明显。虹膜囊肿和瞳孔阻滞在急性闭角型青光眼中发生率高。晶状体厚度及眼轴长度在急性闭角型青光眼患与慢性闭角型青光眼差异无统计学意义,但前房深度慢性闭角型青光眼患者较浅。46眼(75.41%)行小梁切除术,14眼(22.95%)行抗青光眼联合白内障手术,1眼(1.64%)未行手术。术后并发症有前房积血、低眼压、脉络膜脱离、浅前房及睫状环阻塞性青光眼,多发生在慢性闭角型青光眼术后。结论青年闭角型青光眼因解剖因素在治疗时有其特殊性,急性闭角型青光眼常伴有虹膜囊肿,晶状体比较厚,而慢性闭角型青光眼常因为眼轴短,发病隐匿,术后容易引起并发症,尤其是睫状环阻塞性青光眼,治疗效果较差。

Clinical characteristic of primary angle-closure glaucoma in young people

Objective To analyze the characteristics and treatment efficacy of primary angle-closure glaucoma in young people.Methods The data of 61 eyes of 51 patients with primary angle-closure glaucoma,aged 17-40 years,from Jun.2009 to Jun.2019 in Shanxi Eye Hospital were analyzed retrospectively.The follow-up time was 6 months to 2 years.Results There were 15 males(29.41%)and 36 females(70.59%).The ratio of male to female was 1∶2.4.There were acute angle-closure glaucoma in 21 eyes(34.43%)and chronic angle-closure glaucoma in 40 eyes(65.57%).The visual acuity of patients with acute angle-closure glaucoma was improved and the intraocular pressure was controlled after operation.The incidence of iris cyst and pupil block were high in patients with acute angle-closure glaucoma.There was no significant difference in lens thickness or axial length between acute angle-closure glaucoma and chronic angle-closure glaucoma,but the depth of anterior chamber of chronic angle-closure glaucoma was shallow.Trabeculectomy was performed in 46 eyes(75.41%)and glaucoma combined cataract surgery was performed in 14 eyes(22.95%).One eye(1.64%)had no operation.The postoperative complications included hyphema,low intraocular pressure,choroidal detachment,shallow anterior chamber and ciliary block glaucoma.Most of the complications occurred in chronic angle-closure glaucoma after surgery.Conclusion Angle-closure glaucoma under 40 years old often has its particularity in treatment due to anatomical factors.Acute angle-closure glaucoma accompanied with iris cyst and the lens is relatively thick,while postoperative complications are easy to occur for chronic angle-closure glaucoma due to short axis and concealment.And the treatment efficacy is poor especially for malignant glaucoma.