晶状体囊外摘出联合前部玻璃体切割治疗晶状体半脱位继发青光眼24例  

Clinical investigation of extracapsular lens extraction and anterior vitrectomy for 24 cases with crystalline lens subluxation associated with secondary glaucoma

作　　者：罗肇文[1] 张丰菊[1] 王岳秀[1] 孙志河[1] 

机构地区：[1]大连医科大学附属第一医院眼科,辽宁省大连市116011

出　　处：《眼科新进展》2009年第1期43-45,共3页Recent Advances in Ophthalmology

摘　　要：目的评价晶状体囊外摘出联合前部玻璃体切割治疗晶状体半脱位继发青光眼的疗效。方法晶状体半脱位继发青光眼24例(24眼),平均年龄(65.3±4.6)岁。术前平均视力0.20±0.13,平均眼压为(34.2±10.3)mmHg(1kPa=7.5mm-Hg)。术后随访3～7个月,平均4.8个月,观察术后2周、1个月和3个月的视力和眼压变化情况。结果术后视力逐渐提高,术后2周、1个月和3个月的平均视力分别为0.37±0.03、0.53±0.05和0.62±0.03,术后各时间段间差异有显著统计学意义(P<0.01),且与术前相比差异均有显著统计学意义(P<0.001)。术后眼压呈下降趋势,且呈波动性。术后2周眼压均在21mmHg以下,平均为(17.5±3.5)mmHg。术后1个月时大部分患者眼压不同程度升高,平均为(28.9±5.4)mmHg,与术后2周相比差异有显著统计学意义(P<0.01)。术后3个月时平均眼压为(22.6±4.7)mmHg,与术后2周相比差异无统计学意义,与术后1个月相比差异有显著统计学意义(P<0.01)。结论晶状体囊外摘出联合前部玻璃体切割治疗晶状体半脱位继发青光眼具有良好的手术效果和安全性,术后眼压虽然有波动但长期随访眼压控制效果满意。对于术后眼压波动的机制尚需更深入的研究。Objective To evaluate the efficacy of extracapsular cataract extraction and anterior vitrectomy for the treatment of crystalline lens subluxation associated with secondary glaucoma. Methods A total of 24 eyes in 24 patients with lens subluxation associated with secondary glaucoma were collected, and average age was （65.3 ± 4.6 ）years. The average visual acuity was 0.20± 0.13, and the mean intraocuiar pressure （IOP） was （ 34.2 ±10.3 ） mmHg （ 1 kPa = 7.5 mmHg） before the surgery. All cases were followed up for 3 to 7 months, averaging 4.8 months. The changes of visual acuity and IOP were observed at 2 weeks, 1 month and 3 months after the surgery, respectively. Results The mean visual acuity was improved to 0.37 ± 0.03,0.53 ± 0.05,0.62±0.03 on 2 weeks, 1 month, 3 monthsafter the surgery, respectively. There was statistical significance compared with that before surgery（P 〈 0.001 ）. The IOP dropped and fluctuated according to the follow period before surgery（P 〈0.01 ）. The mean IOP was（ 17.5± 3.5 ） mmHg, （28.9±5.4） imnHg, （22.6 ± 4.7 ） mmHg after the surgery, respectively. The IOP measured on 1 month showed significant difference with that of 2 weeks and 3 months （P 〈 0.01 ）. Conclusions Extracapsular cataract extraction and anterior vitrectomy is an effective procedure in the management of crystalline lens subluxation associated with secondary glaucoma. Further study is needed to assess the mechanism of IOP fluctuation.

关 键 词：晶状体半脱位 继发青光眼 玻璃体切割 

分 类 号：R776.2[医药卫生—眼科]