微小巩膜隧道瓣的白内障超声乳化吸除联合小梁切除术  

Combined phacoemulsificatiion and trabeculectomy in the scleral tunnel microincision sion

作　　者：赵军民[1] 刘钢生[1] 刘杰[1] 杨国科[1] 

机构地区：[1]合肥市第一人民医院眼科,230061

出　　处：《临床眼科杂志》2011年第1期49-51,共3页Journal of Clinical Ophthalmology

摘　　要：目的探讨微小巩膜隧道瓣白内障超声乳化吸除联合小梁切除术的可行性。方法对49例(52只眼)青光眼合并白内障行2.8mm巩膜隧道瓣切口的白内障超声乳化吸除联合巩膜隧道内的小梁切除术。结果 52只眼术后眼压控制满意,术后1周、1个月、3个月及6个月眼压平均值分别为(8.24±3.61)mmHg、(13.22±4.12)mmHg、(12.11±4.23)mmHg及(12.59±4.26)mmHg。取本组术后半年平均眼压与行5.5mm巩膜隧道瓣白内障超声乳化吸除、植入一片式硬性PMMA人工晶状体并联合小梁切除术的56只眼术后6个月平均眼压(13.27±3.84)mmHg进行对比分析,无统计学意义(t=1.7536,P=0.08239)。26只眼手术前后1年随访,视网膜神经纤维层厚度变化无统计学意义(P>0.05)。在52只眼中,术后裸眼视力达到或超过0.8者占61.54%。结论该术式切口小,无需做巩膜瓣,切口无需缝合,并避免滤过过畅,减少了术后散光发生,迅速恢复术后视力,术后反应轻,减少了术后并发症。Objective To research feasibility of the surgery combined phacoemusification and trabeculectomy in the scleral tunnel micrroincision.Methods The surgery combined phacoemusification and trabeculectomy was performed through a identical 2.8mm scleral tunnel incision on 52 eyes of 49 patients with cataract and glaucoma. The incision was dispensed with suture. Fold intraocular lens was implanted on all eyes.Results The control of Intraocular pressure on 36 eyes was desirable. The average postoperative intraocular pressure was （13.70±2.82） mm Hg, （14.86±2.86） mm Hg, （14.77±2.63） mm Hg and （15.00±2.17） mm Hg at one week, one month, three months and six months. As compared with 56 eyes that were performed phacoemusification and trabeculectomy with 5.5mm scleral tunnel incision, there was no statistical difference between the mean both postoperative intraocular pressure at six months （t= 1.7536,P=0.08239 ）. The retinal nerve fiber layer was no statistical difference between the preoperative and postoperative times in one year on the 26 eyes . On the 52 eyes, the postoperative visual activity without correction was 0.8 or better in 61.54%.Conclusion The advantage of this operative method was no scleral flap, the incision was smaller and sutureless, redound to chamber restoration, decrease postoperative astigmatism happened, enhanced postoperative visual activity, reduced postoperative inflammatory responses and complications.

关 键 词：巩膜隧道瓣/微小 超声乳化 小梁切除 

分 类 号：R779.6[医药卫生—眼科]