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先天性青光眼是一种少见的、每12500个活婴中有一个罹患(1/12500)青光眼。先天性青光眼发生在儿童期。最常见的先天性青光眼是原发性婴儿型青光眼。原发性婴儿型青光眼可以按发病年龄来分类。原发性婴儿型青光眼发生年龄不到3月时,其中90%是双侧性的。幸而,先天性青光眼并不总是与早熟和其他先天异常相关。一旦已经怀疑是先天性青光眼,即应对患婴进行检查。如果不到3个月的婴儿发生青光眼,则角膜对眼压的升高是非常敏感的,角膜的透明度和横径没有改变。角膜直径、眼压水平、C/D 比两两之间有定量关系。本文还介绍了较新的测量角膜直径的技术。本文也论证了角膜直径与用超声波测量的眼轴长度的关系,表明角膜直径的敏感度要大于眼轴长度的敏感度。一月以上的婴儿要在全麻下检查以便准确测量角膜直径、C/D 比、眼压和房角表现。各种全麻技术一般都会影响眼压水平。本文介绍了较新的、不影响眼压的全麻技术。治疗:虽然药物治疗,特别是噻吗心胺有些奏效,但是原发性婴儿型青光眼的治疗还是手术治疗。本文指出噻吗心胺的安全性及成功率。房角切开术和小梁切除术已被广为采纳。但是,当房角切开术和小梁切除术都不能控制原发性婴儿型青光眼时,也要试行采取其他改良泄液线的术式。本文将描述这些改良术式。85%以上的原发性婴儿型青光眼的眼压均能控制在低于25mm Hg。然而,视觉预后依然是与发生青光眼时眼功能与术后弱视处理有关。视觉预后并非想象的那么严重。有幸,本病的遗传方式的提出使我们能够提供遗传咨询。既然有关青光眼的处理与治疗已有很多进展,那么青光眼的诊断不再意味着就是盲目。
Congenital glaucoma is a rare one, with 1 in 12,500 live births (1/12500) of glaucoma. Congenital glaucoma occurs in childhood. The most common congenital glaucoma is primary infant glaucoma. Primary infant glaucoma can be classified by age of onset. Primary infant glaucoma occurs less than 3 months of age, of which 90% are bilateral. Fortunately, congenital glaucoma is not always associated with precocious puberty and other congenital abnormalities. Once you have suspected congenital glaucoma, that should be checked for infants. If glaucoma occurs in infants younger than 3 months, the cornea is very sensitive to elevated intraocular pressure and the corneal clarity and diameter are unchanged. Corneal diameter, intraocular pressure, C / D ratio between the two quantitative relationship. This article also introduces newer techniques for measuring corneal diameter. This paper also demonstrates the relationship between corneal diameter and axial length measured with ultrasound, indicating that the corneal diameter is more sensitive than the axial length. Infant more than a month to be checked under general anesthesia in order to accurately measure corneal diameter, C / D ratio, intraocular pressure and angle performance. A variety of general anesthesia techniques will affect the level of intraocular pressure. This article describes the newer, general anesthesia technique that does not affect intraocular pressure. Treatment: Although pharmacotherapy, especially timolol, works somewhat, the treatment of primary infant glaucoma is surgery. This article points out the safety and success rate of timolol. Corner and trabeculectomy have been widely adopted. However, when both angle-angle incision and trabeculectomy are unable to control primary infantile glaucoma, other techniques to improve drainage should also be tried out. This article will describe these modified techniques. More than 85% of primary infant glaucoma IOP can be controlled below 25mmHg. However, visual outcome is still associated with glaucomatous ocular function and postoperative amblyopia. Visual prognosis is not as serious as imagined. Fortunately, the presentation of the genetic mode of the disease allows us to provide genetic counseling. Since there has been much progress in the treatment and treatment of glaucoma, the diagnosis of glaucoma no longer means blindness.