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超声乳化白内障吸除联合房角分离术治疗原发性闭角型青光眼的临床研究 被引量:29

Clinical research on the efficacy of treatment for patients with primary angle-closure glaucoma with the combined surgeries ofphacoemulsification,intraocular lens implantation and goniosynechialysis
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摘要 目的探讨超声乳化白内障吸除、人工晶状体植人联合房角分离对原发性闭角型青光眼治疗的临床效果和安全性。方法连续性选取收治的原发性闭角型青光眼合并有白内障的患者133例145只眼,随机分为超声乳化组(Phaco组)和小梁切除手术组(Trab组)。观察手术前后视力、前房深度、角膜内皮细胞密度、房水流畅系数(C值)、房角及眼压的变化情况并进行统计学处理。平均随访时间(13.2±5.6)个月。结果Phaco组术后视力明显提高而Tr.ab组提高不明显;眼压在6个月时Phaco组由术前(46.47±9.12)mmHg降低为(16.55±4.36)mmHg,Trab组由术前(48.25±7.52)mmHg降低为(16.87±5.01)mmHg,两组手术前后比较差异均有统计学意义;Phaco组前房深度由术前(1.55±0.26)mm加深为(3.38±0.35)mm,房角关闭度数由术前(290+25)度减少到(60±35)度,手术前后比较差异有非常显著性,而Trab组则无明显变化;房水流畅系数(C值)检测两组手术前后比较差异均有显著性改善;角膜内皮细胞密度检测丽组手术前后差异则无显著性。结论超声乳化白内障吸除、人工晶体植入联合房角分离术能够显著地加深前房,开放房角,有效地降低眼压,提高患者视功能,并具有手术安全性高、术后并发症少等优势,是治疗PACG合并自内障患者的一种安全有效的手术方法。 Objective To observe and assess the efficacy of treatment for patients with primary angle-closure glaucoma with the combined surgeries of phacoemulsification, intraocular lens implantation and goniosynechialysisMethods 145eyes of 133 consecutive patients with primary angle-closure glaucoma and cataract were randomized into Phaco group and Trab group; The changes of visual acuity, anterior chamber depth (ACD), extent of PAS, corneal endothelial cell density, coefficient of outflow facility, anterior chamber angle and IOP before and after operation were measured.The average follow-up period was (13.2 ± 5.6) months. Results The visual acutity was improved significiantly after phacoemulsication and no significant difference in Trab group; The IOP significiantly decreased from (46.47± 9.12 )mmHg to ( 16.55± 4.36 )mmHg at 6 months after surgery in phaco group. While in Trab group,the lOP decreased from (48.25± 7.52) mmHg to (16.87± 5.01) mmHg. There were significant differences in two groups before and after surgery;The anterior chamber depth (ACD) was increased from( 1.55± 0.26)mm before surgery to(3.38± 0.35)mm at 3 months after surgery in the phaco group, but there were no significant differences in the trab group; The angle closure decreased fi'om (290 ± 25 ) before surgery to (60±35 ) at three months after surgery in Phaco group, but no signifant difference in Trab group; The C value were increased more significiantly than preoperation in the two groups but there were no signifant difference in two groups before and after surgery with the change of the density of corneal endothelial cells .Conclusion Combined phacoemutsication and IOL implantation and Goniosynechialysis can deepen the anterior chamber depth significiantly,make the anterior chamber angle open ,reduce IOP effectively,improve the patients' visual acuity. It is a safe and effective approach to those patients with PACG and coexisting cataract.
出处 《中国实用眼科杂志》 CSCD 北大核心 2008年第8期775-780,共6页 Chinese Journal of Practical Ophthalmology
基金 河北省医学适用技术追踪项目(GL200318)
关键词 超声乳化 原发性闭角型青光眼 白内障 小梁切除术 房角粘连分离术 Phacoemulsication Primary Angle-closure glaucoma Cataract Trabeculectomy Goniosyneehialysis
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参考文献14

  • 1Greve EL. Primary angle closure glaucoma : extracapsular cataract extraction or filtering procedure ? Int Ophthalmol , 1988 , 12 : 157- 162.
  • 2Kubota T,Toguri l,Onizuka N,etal.Phacoemulsification and in Traocular lens implantation for angle closure glaucoma after the relief of pupiUaryblock.Ophthalmologica, 2003,217( 5 ) : 325-328.
  • 3Hayashi K,Hayashi H,Nakao F,et al.Changes in anterior Chamber angle width and depth after intraocular lens implantation in Eyes with glaucoma.Ophthalmology, 2000,107 (4) : 698-703.
  • 4Salmon J F. Predisposing factors for chronic angle -closure glaucoma. ProgRetin Eye Res ,1999,18 (1) : 121-132.
  • 5周文柄主编.临床青光眼.第二版.北京:人民卫生出版社,2000:161-163.
  • 6Ho CL,Walton DS,Pasquale LR. Lens extraction for angle-closure glaucoma. Int Ophthalmol Clin, 2004,44( 1 ) :213-228.
  • 7Kapur SB. Thelensandangle-closureglaucoma. J Cataract Re Fract Surg,2001,27(2) : 176-177.
  • 8Gunning FP, Greve EL. Lens extraction for uncontrolled angle-Closure glaucoma: long-termfollow-up.JCataractRefract Surg, 1998,24 (10) : 1347-1356.
  • 9Wishart PK, Atkinson PL. Extracapsular cataract extraction and Posterior chamber lens implantation in patients with primary chronic angle-closure glaucoma:effect on intraocular pressure control.Eye, 1989,3(6) :706-712.
  • 10Teekhasaenee C,Ritch R. Combined phacoemulsifieation and goniosynechialysis for uncontrolled chroni eangle-closure glaucoma after acute angle-closure glaucoma.Ophthalmology, 1999,106.

二级参考文献13

  • 1孙先勇,尤毓陆,李勤新,黄华东.原发性青光眼病人角膜内皮细胞密度的测定[J].潍坊医学院学报,1996,18(3):188-190. 被引量:2
  • 2Gunning F P,J Cataract Refract Surg,1998年,24卷,1347页
  • 3Yang C H,J Cataract Refract Surg,1997年,23卷,1109页
  • 4Malaise-stals J,Weekers JF.Corneal endothelial cell density in acute angle-closure glaucoma[J].Ophthalmolo ica 1984; 189(3):104.
  • 5Ollivier FJ,Brooks DE,Komaromy AM,Kallberg ME,Andrew SE,Sapp HL,et al.Corneal thickness and endothelial cell density measured by non-contact specular microscopy and pachymetry in Rhesus meaquea (Macaca mulatta) with laser-induced ocular hypertension[J].Exp Eye Res 2003;76(6):671-674.
  • 6Sihota R,Lakshmaiah NC,Titiyal JS,Dada T,Agarwal HC.Corneal endothelial status in the subtypes of primary angle closure glaucoma[J].Clin Exp Ophthalmol 2003;31(6):492-495.
  • 7Brooks AM,Gillies WE.Effect of angle closure glaucoma and surgical intervention on the corneal endothelium[J].Cornea 1991; 10(6):489-497.
  • 8Jiang H,Song ZY,Lin QH.Morphometric study of the endothelial wound healing following penetrating keratoplasty[J].J Med Coll PLA 1993;8:291.
  • 9周文炳,叶天才.青光眼的角膜内皮细胞观察[J].中华眼科杂志,1990,26(4):209-212. 被引量:20
  • 10卓业鸿,葛坚,林明楷,蓝育青,李莉,叶天才.房水引流管植入术治疗继发性青光眼[J].中山医科大学学报,2000,21(5):394-396. 被引量:7

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