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相关概念视频

Glaucoma: Overview01:25

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Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...
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Updated: Jun 21, 2025

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开放角光眼和富士缩症的眼睛.

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概括
此摘要是机器生成的。

本案例研究讨论了经过Descemet剥离内皮角膜成形术 (DSEK) 后管理不受控制的眼内压力 (IOP) 的情况,该患者有开角玻璃眼 (OAG) 的病史. 它探讨了手术选择和类固醇管理,以保持视力.

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科学领域:

  • 眼科医生 眼科 眼科
  • 视光眼管理 视光眼管理
  • 角膜外科手术 角膜外科手术

背景情况:

  • 一名62岁的女性有开角青光眼 (OAG) 的病史和之前的眼切除术,在Descemet剥离内皮角膜整形术 (DSEK) 后三个月内,左眼的眼内压力 (IOP) 失控.
  • 该患者正在接受IOP的最大耐受性药物治疗,包括乙胺,布里莫尼丁,多胺和蒂莫洛尔,并且还在最近的DSEK中服用处方类固醇.
  • 眼科病史包括中度近视,福克斯缩症和假定的类固醇反应,右眼在没有药物治疗的情况下保持低内血压.

研究的目的:

  • 确定最近接受了Descemet剥离内皮角膜整形手术 (DSEK) 的患者左眼中失控眼内压 (IOP) 的最佳管理策略.
  • 评估停止类固醇治疗对IOP控制的潜在影响,以及进一步进行绿眼瘤手术的必要性.
  • 考虑患者在青光眼发病时的年龄和之前的手术对选择DSEK后的手术干预的影响.

主要方法:

  • 临床检查包括视力敏度,戈德曼平面测音仪,瞳孔评估,视野,裂灯生物显微镜和 fundus 评估.
  • 用视网膜神经纤维层 (RNFL) 的光学连贯性断层 (OCT) 和轴长度测量进行前段成像.
  • 对患者病史的审查,包括以前的玻璃眼外科手术 (垂眼切除术),角膜手术 (DSEK) 和目前的IOP医疗管理.

主要成果:

  • 尽管进行了最大的医疗治疗,但左眼内压力为25mmHg,而右眼内压力为12mmHg.
  • 视力敏度在20/30 (右) 和20/40 (左) 稳定;OCT在两只眼睛中显示稳定中度RNFL稀释.
  • 结膜显示痕,但重复带切除术或Xen Gel支架植入似乎是可行的;角度是开的.

结论:

  • 管理需要平衡IOP控制的必要性与DSEK后进一步的玻璃眼外科手术的风险,考虑到正在进行的类固醇使用.
  • 可以考虑停止使用类固醇来降低内脏压力,但这种决定必须与角膜外科医生对移植存活的建议进行权衡.
  • 诸如重复管切除术或Xen Gel支架之类的手术选择可能是可行的,而手术选择可能会受到患者早期光瘤病史和之前的手术的影响.