超声乳化治疗早期闭角型青光眼是否联合周边虹膜切除术的研究

Study of whether or not to combine peripheral iridotomy with phacoemulsification and intraocular lens implantation for angle-closure glaucoma in the preclinical and presymptomatic phases

摘要:

目的:探讨白内障超声乳化并人工晶状体植入术治疗闭角型青光眼临床前期或先兆期患者术中是否需要联合周边虹膜切除术。方法:40例40眼原发性闭角型青光眼临床前期或先兆期病例,术前随机分成A组(白内障超声乳化+人工晶状体植入)和B组(白内障超声乳化+人工晶状体植入+周边虹膜切除术),对比两组术后视力、眼压、前房深度、Scheie前房角分级进行统计分析。结果:两组病例都未发生黄斑囊样水肿、驱逐性大出血等并发症。1例联合周边虹膜切除的患者出现前房积血,对症治疗后出血吸收。两组病例术后视力较术前提高,术后两组视力、眼压、前房深度、Scheie前房角分级比较差异无显著性。结论:闭角型青光眼临床前期、先兆期采用白内障超声乳化摘除晶状体,可有效预防青光眼的急性发作,并显著提高患者的视力,术中不需要另行周边虹膜切除术。

Abstract:

·AIM:To evaluate whether or not to combine peripheral iridotomy with phacoemulsification and intraocular lens implantation to remedy patients with angle-closure glaucoma in the preclinical and presymptomatic phases.·METHODS:Forty patients 40 eyes with angle-closure glaucoma in the preclinical and presymptomatic phases were randomly divided into two groups:group A(phacoemulsification and intraocular lens implantation)and group B(phacoemulsification and intraocular lens implantation combined with peripheral iridotomy),to statistically analyze the postoperative corrected vision,intraocular pressure,anterior chamber depth,grading of the anterior chamber angle(scheie)of the two groups.·RESULTS:No severe complications occurred in two groups,hyphema occurred in one eye in the group B,and it recovered after symptomatic treatment.The two groups’ corrected vision were improved postoperatively compared with.preoperative.There was no significant diference in the postoperative corrected vision,intraocular pressure,anterior chamber depth,grading of the anterior chamber angle(scheie)between group A and group B.·CONCLUSION:The management of angle-closure glaucoma in the preclinical and presymptomatic phases by phacoemulsification and intraocular lens implantation can prevent its acute on set and improve the corrected vision.It’s not necessary to combine peripheral iridotomy with phacoemulsification and intraocular lens.·