前房穿刺放液术在高眼压持续状态下的临床应用

Clinical Application of Anterior Chamber Paracentesis in Patients with Sustained High Intraocular Pressure

摘要: 目的：探讨前房穿刺放液术治疗高眼压持续状态的疗效。方法：对43例43眼不同类型的青光眼患者，经全身和局部给以达饱和剂量的降眼压药物治疗后，眼压仍居高不降呈持续状态，为减轻病人痛苦、缓解症状、迅速降低眼压，为以后手术治疗创造条件，采取紧急措施进行前房穿刺术放液治疗，房水放出过程中，见角膜已变清亮、眼压正常即可停止放液结束穿刺。结果：所有不同类型的青光眼高眼压持续状态患者，经施行前房穿刺放出适量房水后，眼压即刻明显降低，眼胀头痛等症状明显缓解，视力均有不同程度的提高，危急重症得到缓解控制，所有患者均无明显并发症发生。结论：前房穿刺放液术，是青光眼经药物降眼压达饱和剂量治疗后，眼压仍居高不降呈持续状态下，所采取的简单便捷、安全有效的应急措施和方法，避免了长期大量应用降眼压药物引起的副作用，迅速降低眼压提高视力，缓解症状减轻了患者的痛苦，防止高眼压造成的视功能损害，为保证再次手术的安全和疗效创造了有利条件。

Abstract: Aim: To observe the therapeutic effect of anterior chamber paracentesis in glaucoma patients with sustained high intraocular pressure (IOP). Methods: 43 patients with 43 different glaucoma types, after systemic and local ocular hypotensive medication of saturated dose, continued to hold high intraocular pressure which did not fall and was in a sustained state. In order to alleviate the suf-fering of patients, relieve symptoms and quickly reduce eye pressure to create the conditions for future surgery, urgent measures were taken using anterior chamber paracentesis. In the aqueous release process, tapping and puncture could be stopped when the cornea became clear and intra-ocular pressure was normal. Results: After implementation of paracentesis releasing the right amount of aqueous humor, among the patients of different glaucoma types with sustained high intraocular pressure, intraocular pressure decreased immediately; eye swelling, headache and other symptoms were relieved; visual acuity improved to varying degrees; severe crisis was eased under control; and all patients had no significant complications. Conclusion: Anterior chamber pa-racentesis is a safe and effective emergency way used after ocular hypotensive medication of satu-rated dose in patients with sustained high intraocular pressure, which can avoid long-term IOP- lowering drug-induced side effects, quickly reduce intraocular pressure and improve vision, relieve symptoms to alleviate the suffering of patients, and prevent visual impairment caused by high intraocular pressure, in order to create favorable conditions for the safety and efficiency of reoperation.