超声乳化联合前段玻璃体切割与房角分离治疗白内障晶状体半脱位合并闭角型青光眼的临床研究  

Phacoemulsification and anterior vitrectomy combined with goniosynechialysis for cataract lens subluxation associated with angle-closure glaucoma

作　　者：王泳[1] 冯松福[2] 邓金印[1] 

机构地区：[1]广州军区广州总医院眼科,广东省广州市510010 [2]广州中医药大学,广东省广州市510010

出　　处：《眼科新进展》2011年第5期477-479,共3页Recent Advances in Ophthalmology

摘　　要：目的探讨超声乳化联合前段玻璃体切割和钝性房角分离治疗闭角型青光眼合并白内障晶体半脱位的临床疗效及可行性。方法采用超声乳化联合前段玻璃体切割后房型人工晶状体植入和钝性房角分离法治疗18例(18眼)伴有白内障晶状体半脱位的闭角型青光眼患者,回顾分析其临床资料,对手术技巧、术后视力、眼压、前房深度、前房角及并发症进行探讨。结果 18例(18眼)患者术后1d、1周和3个月的平均视力分别为0.30±0.41、0.37±0.32和0.52±0.36,较术前平均视力0.15±0.19明显提高,差异均有统计学意义(均为P<0.05)。术后1d、1周、3个月平均眼压分别为(18.3±7.8)mmHg(1kPa=7.5mmHg)、(15.8±3.9)mmHg、(16.2±2.6)mmHg,与术前用药前平均眼压(30.7±6.5)mmHg及药物治疗后平均眼压(17.2±4.8)mmHg比较,差异均有统计学意义(均为P<0.05)。术后3个月前房深度(3.04±0.38)mm较术前(1.98±0.31)mm显著增加(P<0.05);术后患者房角均较术前增宽,房角粘连关闭象限不同程度开放,无严重并发症发生。结论超声乳化联合前段玻璃体切割后房型人工晶状体植入和钝性房角分离治疗白内障晶状体半脱位合并闭角型青光眼是一种安全、有效、可行的手术方式。Objective To evaluate the curative efficacy and feasibility of phacoemulsification and anterior vitrectomy combined with goniosynechialysis for cataract lens subluxation associated with angle-closure glaucoma.Methods Eighteen eyes of 18 patients suffered from cataract lens subluxation associated with angle-closure glaucoma underwent phacoemulsification and anterior vitrectomy combined with goniosynechialysis were retrospectively studied.Surgery techniques,postoperative visual acuity,intraocular pressure,anterior chamber depth,anterior chamber angle and complications were observed.Results The average visual acuities after surgery were significantly improved to 0.30±0.41,0.37±0.32,0.52±0.36 at 1 day,1 week,3 months,respectively,compared with that before surgery 0.15±0.19,there were statistical differences（all P〈0.05）.The mean intraocular pressure was significantly decreased from preoperatively（30.7±6.5）mmHg（1 kPa=7.5 mmHg）without drug treatment and（17.2±4.8）mmHg with drug to（18.3±7.8）mmHg at 1 day,（15.8±3.9）mmHg at 1 week,（16.2 ±2.6）mmHg at 3 months post-operatively,there were statistical differences（all P〈0.05）.The mean central anterior chamber depth was increased from（1.98±0.31）mm preoperatively to（3.04±0.38）mm at 3 months post-operatively,there was statistical difference（P〈0.05）.The angle of anterior chamber in all eyes became wider at different degrees post-operatively.No severe complication was observed.Conclusion It is safe and efficient to choose phacoemulsification and anterior vitrectomy combined with goniosynechialysis for cataract lens subluxation associated with angle-closure glaucoma.

关 键 词：超声乳化 玻璃体切割 白内障 晶体半脱位 闭角型青光眼 

分 类 号：R776.1[医药卫生—眼科]