摘要
目的观察直接房角镜下钝性机械性房角分离术联合瞳孔成形术治疗白内障术后人工晶体眼继发闭角型青光眼的疗效。方法 10例(11只眼)白内障术后人工晶体眼继发闭角型青光眼患者,均接受直接房角镜下钝性机械性房角分离术联合瞳孔成形术治疗,观察比较手术前后患者眼压、房角开放程度、术后并发症发生情况以及视力。结果患者术后1周、1个月、3个月、6个月的眼压分别为(16.9±2.6)、(17.5±2.5)、(15.4±1.5)、(15.3±1.0)mm Hg(1 mm Hg=0.133 kPa)均低于手术前的(34.7±3.2)mm Hg,差异均具有统计学意义(P<0.05)。11只眼术前房角开放程度均在30~60°之间,术后1个月房角镜检查房角开放程度均>270°。11只眼仅有1只术后第1天少许前房积血,通过药物治疗3 d好转。3只眼术后1个月矫正视力有不同程度提高,余8只眼视力无明显变化;术前、术后1个月最佳矫正视力比较,差异无统计学意义(Z=0.8967, P>0.05)。结论直接房角镜下钝性机械性房角分离术治疗人工晶体眼继发闭角型青光眼,具有操作相对简单、效果明确、并发症少等优点,且同时行瞳孔成形术,视觉质量也会有所改善。
Objective To observe the efficacy of mechanical goniosynechialysis under direct gonioscopy combined with pupilloplasty in the treatment of secondary angle closure glaucoma after cataract surgery. Methods There were 10 patients(11 eyes) with secondary angle closure glaucoma after cataract surgery, and all patients undergone cataract extraction combined with direct gonioscopic mechanical angle separation combined with pupilloplasty. The intraocular pressure, angle opening degree, occurrence of postoperative complications and visual acuity were compared before and after operation. Results The intraocular pressure at 1 week, 1 month, 3 months and 6 months after operation were(16.9±2.6),(17.5±2.5),(15.4±1.5),(15.3±1.0) mm Hg(1 mm Hg=0.133 kPa) lower than that before operation(34.7±3.2) mm Hg, and the difference was statistically significant(P<0.05). The angle opening degree was 30-60° before operation in 11 eyes, and all >270° at 1 month after operation. In 11 eyes, only 1 eye had a little hyphema on the 1 st day after operation, which was improved on the 3 rd day after drug treatment. The corrected visual acuity of 3 eyes was improved to some extent 1 month after operation, and the other 8 eyes had no significant change. There was no significant difference in the best corrected visual acuity before and 1 month after operation(Z=0.8967, P>0.05). Conclusion Direct gonioscopic mechanical angle separation is effective in the treatment of secondary angle closure glaucoma cases after phacoemulsification combined with intraocular lens implantation surgery. The surgery operation is relatively simple, and it has less complications. Also the visual acuity and visual quality recovery a little because of the pupilloplasty surgery.
作者
夏阳
蔺云霞
徐玲
XIA Yang;LIN Yun-xia;XU Ling(He's Ophthalmic Hospital of He's Medical College,Shenyang 110034,China)
出处
《中国实用医药》
2019年第35期21-23,共3页
China Practical Medicine
