【摘要】 目的选择晚期青光眼病例,就其青光眼手术后的视功能状况作随访,以期指导临床治疗策略的制定。方法晚期青光眼患者43例(46眼),随访7～60个月(27.5±15.9个月)。疗效判定标准:抗青光跟手术后不用或仅用局部降眼压药物,眼压≤21mmHg,且视野缺损不进展者作为手术成功标准。结果患者1、2、3、4、5年的手术成功率分别为87.0%、78.3%、69.6%、60.9%及56.5%,平均随访眼压值升高是手术成功率的危险因素(P=0.012)。术后并发白内障(t=-2.954,P=0.005)及平均随访眼压升高(t=-2.551,P=0.014)是术后视力下降的危险因素。术后平均随访眼压值升高是视野缩小的危险因素(P=0.012)。结论治疗晚期青光眼,控制眼压至关重要,但不能以正常统计学范同的眼压值为目标,应寻找其靶眼压。更多还原

【Abstract】 Purpose To study the postoperative visual functions in advanced glaucoma patients.Methods Forty- three advanced glaucoma patients(46 eyes)were followed up 7～60(27.5±15.9)months postoperatively.The definition of sucessful surgery:intraocular pressure(IOP)≤21mmHg and no progressive visual field defect after antiglaucoma surgery.Results The success rate of operation was 87.0% 78.3% 69.6% 60.9% and 56.5% at 1,2,3,4,5 years respectively and it was found that the increased mean follow-up IOP was associated with low success rate of surgery(P= 0.012).The risk factors responsible for reduced postoperative best corrected visual acuity(BCVA)were complicated cataract after surgery(t=-2.954,P=0.005)and the increased mean follow-up IOP(t=-2.551,P=0.014).It was found that the increased mean follow-up IOP was the risk factor for the progression of the visual field postoperatively(P=0.012) Conclusion It is target pressure not the IOP among the statistical range that is important for defect the therapy of glaucoma especially advanced glaucoma.更多还原