白内障青光眼联合手术治疗青光眼合并白内障

Surgery of cataract combined with glaucoma in management of glaucoma complicated cataract

摘要:

目的：探讨白内障超声乳化联合人工晶状体植入及小梁切除术治疗急性闭角型青光眼合并白内障的临床疗效。

方法：选择26例26眼急性闭角型青光眼合并老年性白内障患者作为研究对象，均接受白内障超声乳化联合人工晶状体植入及小梁切除术治疗，观察手术前后视力、眼压、前房深度变化及术后滤过泡形态、术后并发症。

结果：术后6mo时有14例视力≥0.5，10例视力为0.12～0.4，与术前相比视力均有明显改善，手术前后视力比较差异有统计学意义(P<0.05)； 术后1wk； 3，6mo平均眼压分别为12.5±1.2，14.3±1.5，14.6±1.3mmHg，与术前平均眼压相比均明显降低，差异有统计学意义(P<0.05)。术后中央前房深度均明显加深且均形成弥散的功能性滤过泡。术后主要并发症为角膜水肿及前房炎症反应。

结论：白内障超声乳化联合人工晶状体植入及小梁切除术治疗急性闭角型青光眼合并老年性白内障，不仅安全有效，而且术后并发症轻微，值得临床推广应用。

Abstract:

AIM: To investigate the clinical effects of phacoemulsification with intraocular lens implantation and trabeculectomy in management of acute angle-closure glaucoma patients with cataract.

METHODS: Twenty-six cases(26 eyes)with acute angle-closure glaucoma patients with senile cataract all underwent phacoemulsification with intraocular lens implantation and trabeculectomy, the visual acuity, intraocular pressure and anterior chamber depth variation and postoperative bleb morphology, postoperative complications were observed.

RESULTS: Six months after operation, the visual acuity of 14 patients were ≥0.5 and 10 patients were from 0.12 to 0.4, which were improved significantly compared with preoperative, the differences were significantly(P<0.05); the mean intraocular pressure in postoperative 1 week, 3 months and 6 months were respectively 12.5±1.2mmHg, 14.3±1.5mmHg and 14.6±1.3mmHg respectively, which were lowered compared with the preoperative intraocular pressure, the differences were statistically significantly(P<0.05). The postoperative central anterior chamber depth was significantly deepened and functional diffuse blebs were formed. The main complications were corneal edema and anterior chamber inflammation.

CONCLUSION: Phacoemulsification and intraocular lens implantation and trabeculectomy in management of acute angle-closure glaucoma with senile cataract is safe and effective with minor postoperative complications, which deserves clinical application and recommendation.