小切口小梁切除超声乳化治疗青光眼并白内障  

Trabeculectomy combined with phacoemulsification and foldable intraocular lens for glaucoma patients with cataract through small incision

作　　者：白先枝 周雄武[2] 赵长松[2] 

机构地区：[1]湖北省中山医院,湖北武汉430030 [2]华中大学附属同济医院,湖北武汉430022

出　　处：《眼外伤职业眼病杂志》2004年第8期535-536,共2页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的　评价小切口小梁切除联合超声乳化吸出折叠式人工晶状体植入术治疗青光眼合并白内障的效果。方法　应用小切口三联手术对 2 2例 ( 2 3眼 )青光眼合并白内障进行手术治疗。术后随诊 3～ 12月 ,平均 9 4月。结果　术后平均眼压 ( 14 2 3± 3 .47)mmHg( 1mmHg =0 .13 3kPa) ,较术前眼压 ( 16 42± 3 5 .87)mmHg降低了 9.2 3mmHg ,差异有非常显著意义 (P<0 .0 1)。术后矫正视力≥ 0 .5者 16眼 ( 69 5 7% )。术后 2 0眼有散光 ,平均散光度 0 92D。根据Kronfeld分类 ,术后Ⅰ、Ⅱ型滤过泡17眼 ( 73 91% ) ,Ⅲ、Ⅳ型滤过泡 6眼 ( 2 6 0 9% )。术后早期并发浅前房 1眼 ,前房纤维样渗出 3眼 ,少量前房积血 1眼。无一例后发障发生。结论　小切口三联手术治疗青光眼合并白内障 ,视力恢复快、眼压控制好、并发症少。Objective To evelauate the effectiveness of phacoemulsification,fodable intraocular lens implantation and trabeculectomy(triple surgery) in patients of glaucoma with cataract by small-incision.Methods Triple procedure was performed on 23 eyes of 22 patients of glaucoma with cataract.The mean follow-up was 9.4 months(3-12 months).Results The mean postoperative intraocular pressure(IOP) was (14.23±3.4) mmHg(1 mmHg=0.133 kPa) with a mean pressure reduction of 9.86 mmHg ( P<0.01 ).16 eyes (69.575) had a best-corrected visual acuity of ≥0.5 at the lask follow-up (range,0.05-0.8).The mean postoperative astigmatism was 0.92D,3 eyes had no astigmatism.Although 2 eyes used antiglaucoma medication shortly after the surgery,no eyes needed any medications at the last follow-up.The functional blebs by Kronfeld's classification presented in 17 eyes (73.91%),non-functional blebs in 6 eyes(26.09%).The early postoperative complications inclued shallow anterior chamber in 1 eye,hyphema in 1 eye,fibrinous exudation in 2 eyes.No eyes had after cataract.Conclusion The samll-incision triple procedure appears effective for selected patients with cataract and glaucoma,the visula acuity improve rapidly,and intraocular pressure is easy to be controlled with less postoperative complications.

关 键 词：小梁切除术 白内障摘出术 青光眼 白内障 

分 类 号：R779.6[医药卫生—眼科]