白內障手術後房人工水晶體植入後併發惡性青光眼：病例報告

Pseudophakic Malignant Glaucoma: A Case Report

10.6440/TZUCMJ.199206.0110

張乙朝(Yee-Chau Chang)；張國彬(Gor-Bing Chang)；洪伯廷(Por-Tying Hung)

惡性青光眼 ； Chandler氏玻璃體手術 ； Nd-YAG雷射 ； 玻璃體前膜 ； malignant glaucoma ； Chandler's vitreous surgery ； Nd-YAG laser ； anterior hyaloid

慈濟醫學雜誌

4卷2期（1992 / 06 / 01）

110 - 114

繁體中文

一位六十一歲女性病患，在接受左眼白內障超音波乳化摘除術併植入後房人工水晶體後起高眼壓。除了高眼壓外，並觀察到左眼前房變得很淺，由中段虹彩至週邊虹彩均與角膜相接觸。在內科藥物治療失敗下，行手術治療，經玻璃體穿刺抽取房水，週邊虹彩切除術，前房成型術後，前房漸漸變淺且眼壓又高起來，雖再經青光眼藥物治療及睫狀肌麻痺劑點眼下仍無法改善，於是在第一次手術後第三天行第二次手術，除上述手術步驟外，另外以25號針頭將後囊及玻璃體前膜穿刺破。經過此手術後，眼壓維持正常，前房深度保持良好，在歷經三年多之追蹤後仍無復發之現象，我們報告此病例為臨床上懷疑為白內障術後引起惡性青光眼，並以惡性青光眼的治療理念治療成功之一病例。

A 61-year-old woman developed high intraocular pressure after an uncomplicated cataract extraction by phacoemulcification and posterior chamber intraocular lens implantation in her left eye. In addition to high intraocular pressure, very shallow anterior chamber associated with mid-iridocorneal touch were presented in the local examination. After failure of medical treatment, surgical intervention with vitreous aspiration, peripheral iridectomy and anterior chamber air injection were proceeded. Persistant high intraocular pressure and flat chamber recurred gradually after the first operation despite intensive cycloplegics instillation and antiglaucomatous medication. On third day after first operation, second vitreous operation was performed by additional disruption of posterior capsule and anterior hyaloid with 25-gauge needle via peripheral iridectomy. The intraocular pressure was then under control and the anterior chamber remained deep in the three years follow up. We report a successful model treatment based on the curreut concept of malignant glaucoma.