原發(fā)性閉角型青光眼的治療

高翔 夏亮 楊亞斌

摘 要：原發(fā)性閉角型青光眼是我國(guó)青光眼的主要類型，也是致盲的主要原因之一。原發(fā)性閉角型青光眼由于治療的不及時(shí)或治療不當(dāng)，隨著病情的進(jìn)展，可最終導(dǎo)致失明，其病因主要是由多種因素導(dǎo)致房角關(guān)閉使眼壓升高，進(jìn)而視神經(jīng)受損所致。目前對(duì)于原發(fā)性閉角型青光眼的治療多種多樣，但由于引起房角關(guān)閉的因素多樣化，導(dǎo)致我們?cè)谶x擇治療方式上存在諸多困惑。為了原發(fā)性閉角型青光眼能盡早的給與恰當(dāng)?shù)闹委熂邦A(yù)防，諸多學(xué)者和臨床醫(yī)師對(duì)原發(fā)性閉角型青光眼的發(fā)病機(jī)制和治療做了大量研究，也對(duì)原發(fā)性閉角型青光眼的手術(shù)治療方式做了許多改進(jìn)，為原發(fā)性閉角型青光眼的治療提供了新方法新思路。

關(guān)鍵詞：原發(fā)性閉角型青光眼；藥物治療；激光治療；手術(shù)治療

中圖分類號(hào)：R775.2 文獻(xiàn)標(biāo)識(shí)碼：A DOI：10.3969/j.issn.1006-1959.2018.23.015

文章編號(hào)：1006-1959（2018）23-0051-04

Abstract：Primary Angleclosure glaucoma is the main type of glaucoma in China and one of the main causes of blindness. Primary angleclosure glaucoma can eventually lead to blindness as the treatment is not timely or inappropriate， with the progression of the disease， and its etiology is mainly caused by a variety of factors leading to the closure of the Angle of the atrium to increase the intraocular pressure， and then the damage to the optic nerve. At present， there are various treatments for primary angleclosure glaucoma. However， due to the diversity of factors leading to corner closure， there are many puzzles in our choice of treatment. Of primary angle-closure glaucoma can as soon as possible in order to give proper treatment and prevention， many scholars and clinicians in the pathogenesis and treatment of primary angleclosure glaucoma， done a lot of research on the surgical treatment of primary angleclosure glaucoma also do a lot of improvement， which provides a new way for the treatment of primary angleclosure glaucoma.

Key words：Primary angleclosure glaucoma；Drug therapy；Laser therapy；Surgical treatment

原發(fā)性閉角型青光眼（primary angle closure glaucoma，PACG）作為我國(guó)主要致盲眼病之一，但它的發(fā)病存在地域差異性及個(gè)體差異性，治療方式的選擇也存在多樣性，隨著病程的進(jìn)展，視神經(jīng)萎縮導(dǎo)致視力損害，甚至失明[1，2]。如何根據(jù)不同個(gè)體對(duì)治療方案作出準(zhǔn)確的、針對(duì)性的選擇，最大限度的保護(hù)視神經(jīng)或減緩視神經(jīng)的損害，諸多學(xué)者對(duì)PACG的發(fā)病機(jī)制做了大量研究，認(rèn)為導(dǎo)致前房變淺的因素很多。目前治療PACG主要以手術(shù)治療為主，藥物治療為輔，盡可能早期發(fā)現(xiàn)，早期治療與預(yù)防。本研究對(duì)PACG的發(fā)病機(jī)制和治療綜述如下。

1發(fā)病機(jī)制