超声乳化白内障吸除术治疗1/2以上房角关闭的闭角型青光眼  

Clinical efficacy of phacoemulsification in treating angle-closure glaucoma with more than 1/2 angle closure

作　　者：吴晓红[1] 尹忠贵[1] 王巍[1] 

机构地区：[1]上海市浦东新区人民医院眼科,201200

出　　处：《眼科新进展》2009年第12期940-942,共3页Recent Advances in Ophthalmology

摘　　要：目的观察超声乳化白内障吸除术治疗1/2以上房角关闭的闭角型青光眼的临床效果。方法对伴有白内障的原发性闭角型青光眼房角关闭1/2以上的连续病例10例11眼行超声乳化白内障吸除术,术后随访观察12个月,比较手术前后的平均眼压、中央前房深度和房角变化,观察手术后眼压控制情况。结果11眼患者术后第5天的平均眼压与术前相当,术后1个月、3个月、6个月、12个月的平均眼压均较术前低,经比较差异均有统计学意义(t值分别为2.29、2.29、2.13、2.01,均为P<0.05)。术后12个月时,8眼(72.73%)眼压控制(6～21mmHg;1kPa=7.5mmHg),3眼(27.27%)需用1～2种降眼压药物控制眼压;术前平均中央前房深度为(1.92±0.34)mm,术后3个月、12个月时平均中央前房深度分别为(3.26±0.43)mm、(3.26±0.37)mm,术后较术前前房加深,经比较差异均有统计意义(t值分别为-8.10、-8.83;均为P<0.001);术后前房角镜检查虹膜周边变平坦或后陷,房角明显增宽,部分房角重新开放。结论超声乳化白内障吸除术治疗1/2以上房角关闭的闭角型青光眼能够有效降低眼压,加深前房深度并且使房角不同程度开放,控制病情进展。Objective To investigate the clinical efficacy of phacoemulsification in treating angle-closure glaucoma with more than 1/2 angle closure.Methods Phacoemulsification was taken in consecutive 10 cataract cases with primary anglelosure glaucoma（11 eyes）with more than 1/2 angle closure.All cases were followed up for 12 months.The average intraocular pressure（IOP）,central anterior chamber depth and changes of angle were compared between before and after operation,and the control level of IOP was observed after operation. Results At the 5th day after operation,the average IOP of 11 eyes was at the same level as that before operation. The average IOP at 1 month,3 months,5 months and 12 months after operation were lower than that before operation （ t = 2.29,2.29,2.13,2.01 ; all P 〈 0.05 ）. At 12 months after operation, IOP of 8 eyes（72.73% ） controlled at 5 mmHg to 21 mmHg（ 1 kPa =7.5 mmHg）,and 3 eyes （27.27%） needed one or two anti-IOP drugs to control IOP. The average central anterior chamber depth were （ 1.92± 0.34 ） mm, （ 3.26 ± 0.43 ） mm and （ 3.26± 0.37 ）mm before operation, at 3 months and 12 months after operation, and there was statistical difference between that before and after operation （ t = - 8.10, - 8.83 ; both P 〈 0.001 ）. The peripheral iris became flat or took back, the chamber angle significantly widened and part chamber angle opened again with gonioscopy after operation. Conclusion Phacoemulsification can effectively reduce IOP, deepen anterior chamber depth, open chamber angle at various degrees and control pathological progress for angle-closure with more than 1/2 angle closure.

关 键 词：超声乳化白内障吸除术 青光眼 闭角型 

分 类 号：R775.2[医药卫生—眼科]