Clinical Analysis Of 345 Cases Refractory Glaucoma

Objective: To analyze the causes, treatment and result of 345 cases refractory glaucoma.Methods: Retrospective analysis includes 345 refractory glaucoma patients, who had received treatment from January, 2003 to December,2008 at the Department of Ophthalmology, the First Affiliated Hospital, Guangxi Medical University.Results: In 345 refractory glaucoma patients, traumatic glaucoma accounts for 45.64%; neovascular glaucoma for 20.06%; uncontrolled glaucoma with the ever filtering surgery for 8.43%; uveal inflammatory glaucoma for 7.56%; glaucoma after silicone oil injection for 6.4%; aphakic and pseudophakic glaucoma for 5.52%; congenital glaucoma for 5.52%; glaucoma secondary to retinal detachment surgery for 0.58%; glaucoma secondary to vitrectomy for 0.29% .Single treatment of glaucoma surgery accounted for 53.89%, treatment only aiming at cause is 25.65%, single drug treatment occupies 10.62%, cause treatment combine with anti-glaucoma ones is 6.22%, 2.33% automatic discharge, enucleation is 1.3%. Before treatment, mean IOP was 42.15± 17.68mmHg, and the average IOP after treatment was 14.39±9.03mmaHg. It is indicating that after treatment, intraocular pressure of early period can be effectively controlled ( by t test, P<0.05 ). Besides, comparison of visual acuity before and after treatment shows no significant difference ( by t test, P> 0.05 ).Results: In this study, the primary disease of refractory glaucoma with traumatic most ,who accounts for 45.64%; neovascular glaucoma (NVG) accounts for 20.06% followed; with the history of filtering surgery failure accounts for 8.43%; uveal inflammatory accounting for 7.56%; 6.4% after silicone oil injection; no lens or intraocular lens eyes accounted for 5.52%; of young people accounted for 5.52%, or developmental; retinal detachment surgery accounted for 0.58%;accounting for 0.29% after vitrectomy. Single treatment of glaucoma surgery accounted for 53.89%, treatment only aiming at cause is 25.65%, single drug treatment occupies 10.62%, cause treatment combine with anti-glaucoma ones is 6.22%, 2.33% automatic discharge, enucleation is 1.3%. Before treatment, mean IOP was 42.15±17.68mmHg, and the average IOP after treatment was 14.39±9.03mmaHg. It is indicating that after treatment, intraocular pressure of early period can be effectively controlled ( by t test, P<0.05 ). Besides, comparison of visual acuity before and after treatment shows no significant difference ( by t test, P> 0.05 ).Conclusion:①traumatic glaucoma 45.64%; NVG20.06%; uncontrolled glaucoma with the ever filtering surgery for 8.43% . in this study.②Treatment:first to anti-glaucoma surgery—trabeculectomy with MMC.second to aqueous drainage device implantation , final to surgical destruction of the ciliary body③refractory glaucoma were treated can receive a satisfactory intraocular pressure in the early period (two weeks), but the long-term effect needs further study.