目的:观察急性闭角型青光眼急性发作缓解后继发睫状体脉络膜脱离时眼压、前房深度的变化,探讨继发性睫状体脱离的原因、临床特征及治疗效果。方法:回顾性分析我院2011-08/11住院治疗的84例急性闭角型青光眼急性发作的患者,发作缓解后,经超声生物显微镜(UBM)及B超发现,19例出现睫状体脉络膜脱离,用非接触式眼压计及UBM测量急性发作前后和睫状体脉络膜脱离时的眼压和前房深度,并进行统计学分析。结果:急性发作期眼压50.4±6.5mmHg,中央前房深度1.65±0.12mm;发作缓解继发睫状体脉络膜脱离时眼压7.93±4.3mmHg,中央前房深度1.29±0.1mm。UBM及B超检查显示:继发单纯脉络膜脱离10例,单纯睫状体脱离4例,睫状体脉络膜脱离5例,给予常规抗青光眼手术联合适量糖皮质激素治疗,全部睫状体脉络膜脱离均复位。结论:急性闭角型青光眼急性发作缓解后常可合并睫状体及脉络膜脱离,且治疗前眼压越高,缓解时间越短,缓解后发生睫状体、脉络膜脱离的几率越高,其直接征象为眼压过低、前房更浅,UBM为其最可靠的检查方法,常规抗青光眼手术联合适量糖皮质激素为该类患者的有效治疗方法。
AIM:To observe the change of intraocular pressure(IOP),anterior chamber depth,causes,and clinical features and treatment of the secondary ciliary body detachment after remission of the acute attack of primary acute angle-closure glaucoma(PACG).METHODS:Clinical data of 84 patients 84 eyes with PACG from August 1,2011 to November 30,2011 were retrospectively analyzed.Nineteen PACG patients 19 eyes were determined with choroidal or ciliary detachment by ultrasound biomicroscope(UBM) and B ultrasound examination.The anterior anatomical features,UBM and B ultrasound imaging,as well as the treatment outcome of those patients were analyzed.RESULTS:The IOP was(50.4±6.5)mmHg and the central anterior chamber depth was(1.65±0.12)mm in eyes without choroidal or ciliary detachment;and the IOP was(7.93±4.3)mmHg and the central anterior chamber depth was(1.29±0.1)mm in eyes with choroidal or ciliary detachment.UBM and B-ultrasound:secondary choroidal detachment in 10 cases,ciliary body detachment in 4 cases,choroidal and ciliary detachment in 5 cases,all cases received the conventional glaucoma surgery combined with appropriate amount of glucocorticoid treatment,and all of the detachment was reset.CONCLUSION:Acute attack of PACG can often cause ciliary body and choroidal detachment,and pre-treatment IOP is higher.The duration of remission is shorter.The choroid and ciliary are in the higher risk of detachment.The direct sign of choroidal or ciliary detachment is low IOP,shallower anterior chamber,and it's most reliable way to check is UBM.The conventional anti-glaucoma surgery combined with the amount of glucocorticoid is effective treatment for these patients.