摘要
目的探讨原发性青光眼合并白内障手术方式临床效果。方法本组53例63眼,根据房角粘连情况将38例48眼闭角青光眼合并白内障患者分为：房角粘连关闭≤180°12眼,采用超乳联合房角分离术;180°〈房角粘连关闭≤270°20眼,采用超乳联合房角分离、虹膜周边切除术;房角粘连关闭〉270°16眼,采用超乳、房角分离联合小梁切除术（简称三联）,15例开角型青光眼合并白内障,视力低于0.4者,行超乳联合小梁切除术,随访3个月-5年,对比术前、术后的视力、眼压、前房深度及前房角变化。结果 29眼急性闭角型青光眼和19眼慢性闭角型青光眼术后眼压控制在正常范围,视力恢复良好;6只慢性闭角型青光眼房角粘连〉2/3,术后近期眼压控制好,术后1.8-2.0年眼压再次增高,药物效果好,眼压控制在正常范围。15例开角型青光眼合并白内障者,术后视力均提高,术后眼压12眼控制正常范围,3眼术后近期眼压控制好,1.0-1.5年眼压再次增高,药物控制眼压良好。结论对于原发性闭角型青光眼合并白内障患者,根据房角关闭情况：行超乳联合房角分离术、虹膜周边切除术超乳联合小梁切除术（三联术）,开角性青光眼合并白内障患者,超乳联合小梁切除术可有效控制眼压,但仍需长期随访。
Objective To study the clinical effect of the surgery way of primary glaucoma complicated with cataract. Methods Of the 53 cases with 63 eyes,38 cases（48 eyes） with angle-closure glaucoma complicated with cataract were divided into 12 eyes with closed goniosynechia ≤ 180° treated by phacoemulsification combined with goniosynechialysis,16 eyes with closed goniosynechia between 180 ° and 270 ° treated by phacoemulsification,goniosynechialysis combined with peripheral iridectomy,16 eyes with closed goniosynechia 〉270 ° treated by phacoemulsification,goniosynechialysis combined with trabeculectomy（triple）. Of the 15 cases with open angle glaucoma complicated with cataract,the patients who had the visual acuity lower than 0.4 were treated by phacoemulsification combined with trabeculectomy and were follow-up from 3 months to 5 years. To compare the visual acuity,intraocular pressure（IOP）,anterior chamber depth and the changes of anterior chamber angle of before and after surgery. Results The intraocular pressure had been controlled in the normal range and the visual acuity had been good recovery in 29 eyes with acute angle-closure glaucoma and 19 eyes with chronic angle-closure glaucoma. 6 eyes with chronic angleclosure glaucoma had goniosynechia 〉2/3 and got effective IOP control. Drug had got effective to control the IOP which had increased again after 1.8 to 2 years later to be in normal range. Of the 15 patients with open angle glaucoma complicated with cataract,the postoperative visual acuity was improved,the postoperative IOP was that,12 eyes were controlled in normal range,3 eyes which had increased again after 1.0 to 1.5 years later were controlled by drug in normal range. Conclusion According to the closed goniosynechia to select phacoemulsification combined with goniosynechialysis or peripheral iridectomy phacoemulsification combined with trabeculectomy（triple）. Phacoemulsification combined with trabeculectomy could effectively control the IOP of patients with open angle glaucoma complicated with cataract,but should be followed-up for long term.
出处
《中国医药科学》
2014年第22期28-31,共4页
China Medicine And Pharmacy
关键词
青光眼
闭角型
开角型
白内障
评价
Glaucoma
Angle-closure
Open-angle
Cataract
Evaluation
