Clinical and Experimental Study on Malignant Glaucoma

1)恶性青光眼的临床研究：分析激光虹膜切开术后2例、视网膜中央静脉闭塞3例、原田病3例、葡萄膜积液2例、多灶后色素性青光眼病1例、颈动脉海绵窦瘘1例、视网膜脱离手术后8例恶性青光眼的临床表现及生物特征。除视网膜脱离外，其余眼内病变均为女性，除1例原田病高度近视外，其余视轴长度均短于正常值。在所有病例中，心肌病-睫状体麻痹治疗是有效的，但在某些情况下，不足以控制眼压。虹膜切开术的效果值得怀疑，但在某些情况下不能排除瞳孔阻滞的影响。2)前列腺素e2在家兔体内的实验研究：局部应用前列腺素e2 （PEG_2）可使睫状体血流量增加，睫状体明显肿胀。应用PEG_2后眼压立即升高，但前腔深度仅随高剂量PEG_2的应用而增加。先前应用匹罗卡品对这些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，我们提出了恶性青光眼的发病机制和治疗方案。

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.