白内障手术前后闭角型青光眼前房角镜观察  

Gonioscopy after phacoemulsification in eyes with primary angle-closure glaucoma.

作　　者：郑磊[1] 张建华[1] 柳林[1] 仲明[1] 沈炜[1] 刘志勇[1] 张媛[1] 吴晋辉[1] 

机构地区：[1]第二军医大学第一附属医院眼科,上海200433

出　　处：《眼外伤职业眼病杂志》2005年第10期737-739,共3页Journal of Injuries and Occupational Diseases of the Eye with Ophthalmic Surgeries

摘　　要：目的观察单纯超声乳化吸出术治疗伴有白内障的闭角型青光眼手术前后前房角的改变.方法单纯用白内障超声乳化吸出后房人工晶状体植入术治疗闭角型青光眼并发白内障16例(25眼).术前术后常规做视力、裂隙灯显微镜、非接触眼压计检查、前房深度检查及Coldmann前房角镜检查.随访3～18月.结果前房角镜检查:16例(25眼)术前前房角关闭粘连＜1/4圆周者4眼,1/4～1/2圆周者7眼,3/4圆周者5眼,＞3/4圆周者9眼.术后前房角均有增宽,前房角关闭及周边虹膜前粘连范围减小,部分患眼前房角重新开放,其中前房角全部开放12眼,仍存1/4～1/2圆周前房角粘连4眼,小于1/4圆周前房角粘连9眼.随访3～18月未见前房角关闭粘连范围扩大.术后视力均有不同程度提高,前房深度增加,眼压正常.结论超声乳化吸出术治疗闭角型青光眼伴白内障术后前房角增宽或开放,原关闭粘连范围减小,眼压正常,效果良好.Objective To investigate the change of anterior chamber angle in eyes with primary angle-closure glaucoma after phacoemul-sification and posterior chamber intraocular lens implantation. Methods 16 patients （25 eyes） who underwent a successful phacoemulsification for primary angle-closure glaucoma with cataract were included in a non-randomized clinical study. Examination was taken pre- and post- operatively. The examinations included visual acuity, tonometry, depth of anterior chamber and gonioscopy. Results Before operation the gonioscopy showed 4 eyes whose range of closure of angler 〈 90°, 7 eyes in90°-180°, 5 eyes in 180°-270°, 9 eyes 〉270°. The extent of any touch or adhesion between iris and trabecular reduced. The angle opened again in some patients, 360 degrees of angle circumference opened in 12 eyes, there were still angle closure or synechia 90°-180° in 4 eyes, 〈 90° in 9 eyes. The extent of peripheral anterior synechia or angle closure did not enlarge after surgery up to 18 months. Vision of all 25 eyes improved differently, deepening of anterior chamber depth were found, intraocular pressure were normal without medication. Conclusion The anterior chamber angle of primary angle-closure glaucoma after phacoemulsification were wider than preoperation, and the exent of angle-closure or peripheral anterior synechia reduced.

关 键 词：闭角型青光眼 超声乳化吸出术 房角镜检查 

分 类 号：R779.6[医药卫生—眼科]