首页|期刊导航|中华医学杂志（英文版）|Combined trabeculectomy and vitrectomy for intractable glaucoma with severe ocular contusion involving the posterior segment
中华医学杂志（英文版）2011，Vol.124Issue(15)：2316-2320,5.DOI:10.3760/cma.j.issn.0366-6999.2011.15.013
Combined trabeculectomy and vitrectomy for intractable glaucoma with severe ocular contusion involving the posterior segment
Combined trabeculectomy and vitrectomy for intractable glaucoma with severe ocular contusion involving the posterior segment
摘要
Abstract
Background Intractable secondary glaucoma with severe ocular contusion involving the posterior segment is difficult to treat. In this study, we evaluated the safety and efficacy of combined trabeculectomy and vitrectomy for intractable glaucoma with severe ocular contusion involving the posterior segment. Methods This retrospective interventional study enrolled 18 eyes from 18 consecutive cases with uncontrolled intraocular pressure, angle recession exceeding 180°, dense vitreous hemorrhage, and/or limited retinal detachment after severe ocular contusion. Combined trabeculectomy and vitrectomy was performed after giving the patient sufficient anti-inflammatory and intraocular pressure (IOP)-lowering medication. Follow-up averaged 26.2 (range, 6.0-48.0)months. Results The mean IOP decreased from (36.4±10.0) mmHg on maximum lOP-lowering medications to (14.6±4.4)mmHg on (0.7±1.2) topical medications at the final follow-up (P <0.0001). During the first postoperative month, four eyes (22%) had a short hypertensive phase and six eyes (33%) had early hypotony, including one case (5.6%) of bleb leakage.Seven eyes (39%) developed recurrent hypertension 3-6 months postoperatively, five of which were controlled by topical medications. Ten (55.6%) eyes were classified as a complete success, five (27.8%) as a qualified success, and three eyes (16.7%) as failures. Kaplan-Meier survival analysis for complete and cumulative success showed 53.5% and 80.0%survival at 48 months, respectively. Visual acuity was improved in 15 eyes (83.3%). Three eyes (16.7%) had unchanged visual acuity, one (5.6%) of which developed atrophia bulbi despite a normal intraocular pressure. No recurrent retinal detachment or vitreous hemorrhage developed. Conclusion Combined trabeculectomy and vitrectomy is a viable surgical procedure for the management of intractable glaucoma with severe ocular contusion involving the posterior segment in selected cases.关键词
trabeculectomy/vitrectomy/glaucoma/ocular traumaKey words
trabeculectomy/vitrectomy/glaucoma/ocular trauma引用本文复制引用
WANG Xiao-yu,HU Rong-rong,SHEN Li-ping,LU Hong,GU Yang-shun..Combined trabeculectomy and vitrectomy for intractable glaucoma with severe ocular contusion involving the posterior segment[J].中华医学杂志（英文版）,2011,124(15):2316-2320,5.基金项目
This work was supported by a grant from the Scientific Research Fund of Zhejiang Provincial Education Department (No.Y200909907). （No.Y200909907）
