Clinical and Experimental Study on Malignant Glaucoma

1)恶性青光眼患者的临床研究：分析2例激光虹膜切开术、3例视网膜中央静脉阻塞、3例原田氏病、2例葡萄膜渗出、1例多灶性后色素变性、1例颈动脉海绵窦瘘和8例视网膜脱离术后患者的临床表现和生物计量学指标。除视网膜脱离外，所有有眼内病理改变的患者均为女性，除1例高度近视的原田氏病患者外，其余患者的眼轴长度均小于正常值。在所有病例中，散瞳-睫状肌麻痹疗法都是有效的，但在某些情况下不足以控制眼压。2)前列腺素E_2对兔的实验研究：局部应用前列腺素E_2使睫状体血流量增加，睫状突明显出汗。用药后即刻眼压升高，但前房深度仅在大剂量用药后才增加。之前应用匹罗卡品对眼压和前房深度的变化没有影响。3)根据这些临床和实验结果，我们对恶性青光眼的机制和治疗提出了一个方案。

1) Clinical Study of Patients with Malignant Glaucoma :Clinical findings and biometric values of two cases after laser iridotomy, 3 cases with central retinal vein occlusion, 3 cases with Harada's disease, 2 cases with uveal efflusion, one case of multifocal posterior pigment eqitheliopathy, one case with carotid cavernous fistula and 8 cases after the retinal detachment surgery, which showed malignat glaucoma, were analysed. All cases with intraocular pathology except for the cases with retinal detachment were female and all cases but one with high myopia of Harada's disease showed optic axis length shorter than the normal value. In all cases mydriatics-cycloplegic therapy was effective, but in some cases not enough to control intraocular pressure. The effect of iridotomy was doubtful, but the effect of pupillary block could not be excluded in some cases.2) Experimental Studies with Prostaglandne E _2 In Rabbits :Topical application of prostaglandin E_2 (PEG_2) increased the blood flow in the ciliary body and showed marked sweelling of the ciliary processes. Intraocular pressure incresed immediately after the application of PEG_2 , but the anteriol chamber depth increased only with an application of high dosage of PEG_2 . No prior application of pilocarpine had effect on these changes in intraocular pressure and anterior chamber depth.3) From these clinical and experimental results we proposed a schema on the mechanism and therapy of malignant glaucoma.