原发性闭角型青光眼小梁切除术后再行白内障超声乳化术的疗效观察  

Effect of Phacoemulsification in Primary Angle-closure Glaucoma with Previous Trabeculectomy

作　　者：王梅[1] 方敏 卓业鸿[3] 凌运兰[3] 林明楷[3] 葛坚[3] 

机构地区：[1]中山大学孙逸仙纪念医院眼科,广东广州510120 [2]深圳市眼科中心,广东深圳518001 [3]中山大学中山眼科中心//眼科学国家重点实验室,广东广州510061

出　　处：《中山大学学报（医学科学版）》2010年第6期740-743,751,共5页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：国家重点基础研究发展规划项目(2007CB512200);十一五广东省医学重点专科项目(粤卫[2008]50号)

摘　　要：【目的】了解原发性闭角型青光眼(PACG)在小梁切除术成功控制眼压后,再施行白内障超声乳化术对眼压的影响。【方法】回顾性分析分次接受小梁切除术、白内障超声乳化术前后PACG患者的眼压、滤过泡以及手术并发症等指标。【结果】分次接受小梁切除术、超声乳化术的PACG患者共11例(11只眼)。两次手术间隔时间平均为22.6(S=14.7)月,超声乳化术后随访时间平均为35.6(S=22.8)月。小梁切除术后,所有眼的眼压均下降,且即使在施行白内障手术后,眼压仍能保持白内障手术前的眼压(P=0.010)。10只眼(90.9%)手术后无需使用降眼压药物,眼压即可控制在21mmHg以下。超声乳化术后功能性滤过泡的成功率为54.5%(6/11眼)。手术后最常见的并发症为虹膜损伤。【结论】PACG小梁切除术后再行白内障超声乳化术是安全的、可行的。【Objective】 To evaluate the effect of temporal corneal phacoemulsification on intraocular pressure （IOP） in eyes with primary angle closure glaucoma （PACG） after successful trabeculectomy. 【Methods】 This retrospective study evaluated the IOP in 11 eyes （11 patients） with PACG that had temporal clear corneal phacoemulsification after trabeculectomy. Pre-and postoperative data including IOP,visual filtering blebs,visual acuity,and complications were analyzed. 【Results】The mean interval between trabeculectomy and phacoemulsification was 22.6±14.7 months and the mean follow-up after phacoemulsification,35.6±22.8 months. The mean IOP was lowered significantly after trabeculectomy,besides,there was no significant difference of IOP at pre-and post-phacoemulsificaiton 1 week and at the last follow-up （F = 8.441,P = 0.010）. IOP were controlled （IOP ≤ 21 mm Hg） in 10 eyes （90.9%） after phacoemulsification without antiglaucoma therapy. Filtering blebs existed in 6 eyes （54.5%） after phacoemulsification. The most common complication was iris trauma. 【Conclusions】 It is safe and effective to control IOP to perform phacoemulsification after successful trabeculectomy in PACG.

关 键 词：原发性闭角型青光眼 小梁切除术 眼压 白内障 

分 类 号：R775.2[医药卫生—眼科]