方法：回顾性分析18例18眼青光眼合并白内障患者(8例男性，10例女性)，其中11眼为原发性急性闭角型青光眼，7眼为晶状体半脱位继发青光眼。所有患者经保守治疗后眼压不能控制，均接受白内障超声乳化并人工晶状体植入术、小梁切除术及巩膜瓣下前段玻璃体切除术。主要观察指标为最佳矫正视力、前房深度、眼压、裂隙灯显微镜、降眼压药物、眼底及并发症情况。

结果：患者平均眼轴为21.5±0.6 mm，平均年龄为62.3±7.9岁。术前平均前房深度0.78±0.43 mm，术后1wk平均前房深度2.89±0.41 mm(P<0.001)。术后1wk平均眼压16.72±6.28 mmHg，较术前平均眼压43.28±9.38 mmHg显著下降(P<0.001)。均未发生如眼内炎、视网膜脱离、脉络膜上腔出血、角膜内皮失代偿、恶性青光眼等并发症。

结论：巩膜瓣下25G前段玻璃体切除术在超声乳化联合小梁切除术治疗极浅前房青光眼合并白内障是安全有效的。

METHODS: This retrospective case review consisted of 18 eyes of 18 patients(8 males and 10 females), of those, 11 eyes had acute angle-closure glaucoma with angle-closure greater than 180 degree, and 7 eyes had lens subluxation combined with glaucoma. All 18 patients underwent phacoemulsification, intraocular lens(IOL)implantation, trabeculectomy, and anterior vitrectomy via the scleral flap in cases where conservative management techniques cannot control intraocular pressure(IOP). The main outcomes were best corrected visual acuity(BCVA), anterior chamber depth(ACD), IOP, slit-lamp microscopic examination, number of medications, fundus examination, and complications.

RESULTS: The average axial length(AL)was 21.5±0.6 mm. Mean age was 62.3±7.9 years. Mean ACD increased significantly from 0.78±0.43 mm to 2.89±0.41 mm 1wk after surgery(P<0.001). Mean IOP decreased significantly from 43.28±9.38 mmHg to 16.72±6.28 mmHg(P<0.001). No serious complications, such as endophthalmitis, retinal detachment, suprachoroidal hemorrhage, corneal decompensation, and malignant glaucoma were observed.

CONCLUSION: 25G anterior vitrectomy via scleral flap is a safe and effective technique for glaucoma and cataract with extremely shallow anterior chamber.