摘要　目的　讨论小梁切除术、巩膜咬切术和虹膜嵌顿术后浅前房的原因和发生情况。方法　回顾性总结1986～1996年在我院眼科进行3种抗青光眼手术的390只各种青光眼病例。结果　(1)术前眼压≤21mmHg(1mmHg=0.133kPa)者109只眼，小梁切除术64只眼，术后浅前房9只眼，占14.1%，巩膜咬切术31只眼，术后浅前房7只眼，占20.6%，虹膜嵌顿术11只眼，术后无浅前房发生；(2)术前眼压22～35mmHg者175只眼，小梁切除术103只眼，术后浅前房26只眼，占25.2%，巩膜咬切术46只眼，术后浅前房15只眼，占32.6%，虹膜嵌顿术26只眼，术后浅前房5只眼，占19.2%;(3)术前眼压＞35mmHg者106只眼，小梁切除术42只眼，术后浅前房13只眼，占31%，巩膜咬切术23只眼，术后浅前房5只眼，占21.7%，虹膜嵌顿术41只眼，术后浅前房5只眼，占12.2%.结论　3种抗青光眼手术中，虹膜嵌顿术后浅前房发生率低；术前眼压控制正常后，术后浅前房发生率低。

Clinical analysis of plateau anterior chamber after

　　three kinds of anti-glaucoma operations

　　LU Yan,GUO Li,WANG Ming-Yang,LI Xia

　　Key words　anti-glaucoma operation;plateau anterior chamber;intraocular pressure

　　Abstract　Objective　To explore the cases of plateau anterior chamber(PAC) after trabeculectomy,slerectoiridectomy and iridencleisis.Method　390 eyes with glaucoma treated with three kinds of anti-glaucoma operations were reviewed retrospectively.Results　(1)In the group (109 eyes) with preoperative intraocular pressure(PIOP)≤21mmHg,sixty-four eyes were treated with trabeculectomy,and 31 eyes with slerectoiridectomy of which there were 9(14.1%) and 7(20.6%) eyes had undergone PAC respectively.There was no PAC in 11 eyes treated with iridencleisis;(2)In the group(175 eyes)with PIOP from 22 to 35 mmHg,there were 26 eyes(25.2%) and 15 eyes(32.6%) developing PAC of 103 eyes treated with trabeculectomy,and 46 eyes with slerectoiridectomy respectively,of 26 eyes with iridencleisis,there were 5 eyes(19.2%) developing PAC;(3)In the group(106 eyes)with PIOP＞35mmHg,there were 13 eyes(31%) developing PAC of 23 eyes with trabeculectomy,5 eyes(21.7%) developing PAC of 23 eyes with slerectoiridectomy.There were 5 eyes(12.2%) developing PAC of 41 eyes with iridencleisis.Conclusion　Iridencleisis has lower PAC incidence;PAC incidence is lower in group with PIOP≤21mmHg.

　　青光眼滤过术后，前房一般于术后24h内形成。术后浅前房或前房延缓形成，是滤过术后较常见，也是较为严重的并发症。持续性浅前房可导致角膜水肿，瞳孔后粘，房角关闭，滤过泡不形成和白内障等一系列后果。本文将就3种抗青光眼手术后浅前房的发生及其原因进行分析、讨论。

　　1　材料和方法

　　1.1　一般资料　本文390只眼均为我院1986～1996年收治的青光眼，其中闭角型青光眼376只，开角型青光眼13只，继发性青光眼1只。行小梁切除术209只眼，巩膜咬切术103只眼，虹膜嵌顿术78只眼。

　　1.2　方法

　　1.2.1　分组　根据术前1wk内眼压分为3组：第一组，眼压≤21mmHg；第二组，眼压22～35mmHg；第三组，眼压＞35mmHg。

　　1.2.2　浅前房标准　术后d1前房消失或周边消失，或术后前房形成后又消失，时间超过2d。

　　2　结果

　　2.1　术前眼压≤21mmHg组3种抗青光眼术后浅前房情况　本组共109眼，行小梁切除术64眼，其中9眼发生浅前房，占14.1%；行巩膜咬切术31眼，其中7眼(20.6%)发生浅前房；行虹膜嵌顿术的11眼无1例发生浅前房。

　　2.2　术前眼压在22～35mmHg组3种抗青光眼术后浅前房发生情况　本组共175眼，行小梁切除术103眼，其中26眼发生浅前房，占25.2%；行巩膜咬切术46眼，其中15眼发生浅前房，占32.6%；行虹膜嵌顿术26眼，其中5眼发生浅前房，占19.2%.

　　2.3　术前眼压＞35mmHg组3种抗青光眼术后浅前房发生情况　本组共106眼，行小梁切除术42眼，其中13眼发生浅前房，占31.0%；行巩膜咬切术23眼，其中5眼发生浅前房，占21.7%；行虹膜嵌顿术的41眼，其中5眼发生浅前房，占12.2%.

　　2.4　3种抗青光眼术后浅前房的原因　见表1。

表1　3种抗青光眼术后浅前房发生原因分析

　　Table 1　Reasons of PAC after three kind

　　of anti-glaucoma operations

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