原发性闭角型青光眼合并白内障超声乳化手术临床观察

Clinical observation of phacoemulsification in management of primary angle-closure glucoma complicated cataract

摘要:

目的:探讨原发性闭角型青光眼合并白内障超声乳化手术疗效。方法:原发性闭角型青光眼合并白内障32眼,其中急性期的28眼行白内障超声乳化手术；慢性期4眼行白内障超声乳化联合小梁切除术。结果:术后第1d,9眼出现角膜内皮线状皱折,5眼角膜基质轻度水肿、混浊,2～4d后消退,角膜恢复透明,房水炎症细胞＋～＋＋,经术后抗炎治疗1wk,前房炎症细胞消失；术后1wk随访,急性期的28眼,眼压均在10~20mmHg之间,慢性期4眼,眼压7~9mmHg。术后2wk随访,所有患者眼压均在10~20mmHg之间。所有患者术后视力均得到不同程度的提高。结论:超声乳化白内障吸除联合人工晶状体植入术,治疗原发性闭角型青光眼合并白内障是一种安全、有效、化繁为简的选择,避免了单纯青光眼术后再次行白内障手术的可能。

Abstract:

AIM:To investigate the surgery effect of phacoemulsification for primary angle-closure glaucoma(PACG) complicated with cataract surgery.METHODS:PACG complicated with cataract were 32 eyes, of which the acute phase of 28 eyes performed phacoemulsification, chronic phase of 4 eyes performed phacoemulsification combined with trabeculectomy.RESULTS:At postoperative 1 day, 9 eyes appeared corneal endothelial linear ruffled, 5 eyes occurred corneal stromal layer mild edema, turbidity cornea, which regressed at postoperative 2-4 days. Corneal restored transparent, causing inflammation cell + to + +. After the anti-inflammatory treatment for 1 week, inflammatory cells in the anterior disappeared. After 1 week follow-up, the acute phase of 28 eyes, intraocular pressure were 10-20mmHg, chronic phase of 4 eyes, intraocular pressure were 7-9mmHg. At postoperative two weeks of follow-up, all patients'' intraocular pressure were 10-20mmHg. Visual acuity of all the patients improved to varying degrees. CONCLUSION:Phacoemulsification combined with IOL implantation for the treatment of PACG complicated with cataract is a safe, effective, change numerous for brief choice, which avoids to re-performing the cataract surgery after pure glaucoma surgery. 