单纯晶状体摘除治疗膨胀期白内障继发青光眼  

Clinical observation of glaucoma secondary to intumescent cataract treated by cataract extraction

作　　者：温跃春[1] 张士倩[1] 顾永昊[1] 

机构地区：[1]安徽医科大学附属省立医院眼科,合肥230001

出　　处：《安徽医学》2009年第8期875-876,共2页Anhui Medical Journal

摘　　要：目的探讨单纯行白内障超声乳化人工晶状体植入治疗白内障膨胀期继发闭角型青光眼的治疗效果。方法2007年间12例白内障膨胀期继发闭角型青光眼患者,入院急诊给予缩瞳、高渗剂等降眼压治疗,术前3天,眼压控制正常,瞳孔能缩小,房角开放1/2以上。术前局部滴用糖皮质激素和非甾体类药物。表麻下行透明角膜切口白内障超声乳化及折叠型人工晶状体植入手术,术中针对膨胀期白内障囊膜脆性大、囊袋内压力高等特点,采取针头穿刺并抽吸部分液化皮质后行CCC,卡巴胆碱缩瞳;术毕结膜下注射甲基强的松龙,并在术后加用甘露醇静脉滴注。结果术后3天视力均>0.3,眼压均在18mmHg以下;11例随访6个月,矫正视力>0.8者10例,未用任何降眼压药物情况下,11例眼压均<18mmHg。术中无特殊并发症,术后并发症有角膜轻中度水肿6例,前房渗出2例,经治疗后吸收。结论只要术前能控制眼压、缩小瞳孔并且房角开放,围手术期处理合理,膨胀期白内障继发急性闭角型青光眼单纯行超声乳化人工晶状体植入,不仅能很好的控制眼压,而且视力恢复良好。Objective Aim To analyze the clinical effect of treating glaucoma secondary to intumescent cataract by cataract extraction. Methods 12 cases of glaucoma secondary to intumescent cataract were treated by miotic, mannitol and catelol to lower the intraocular pressure （IOP） before the operation, and half of the chamber angle was open. ＂Then, patients underwent cataract phaeoemulcification by clear corneal incision combined with implantation of intraocular lens. Some cases＂ cataract cortex were aspirated before continuous circular capsulorhexis. Results All cases＂ visual acuity was better than 0.3 and IOP was less than 18 mmHg 3 days after the operation. After 6 months＂ follow-up, 10 out 11 cases best corrected visual acuity was better than 0.8 and all cases＂ IOP was less than 18 mmHg. There was no serious complication. Conclusion If the patients＂ IOP could be controlled and chamber angle is open, glaucoma secondary to intumescent cataract could be treated by cataract phacoemulcification combined with implantation of intraoeular lens. The patients could get normal IOP and better visual acuity.

关 键 词：超声乳化 白内障 青光眼 

分 类 号：R779.6[医药卫生—眼科]