两种手术方式治疗闭角型青光眼和并老年性白内障的临床观察  

CLINICAL OBSERVATION ON THE TWO SURGICAL TREATMENT OF ANGLE-CLOSURE GLAUCOMA AND SENILE CATARACT

作　　者：张慧[1] 董健鸿[1] 

机构地区：[1]上海市徐汇区中心医院眼科,上海200031

出　　处：《现代预防医学》2011年第13期2657-2659,共3页Modern Preventive Medicine

摘　　要：[目的]研究两种手术方式治疗闭角型青光眼合并老年性白内障的临床疗效对比。[方法]闭角型青光眼合并老年性白内障的患者78例(85只眼),其中A组32眼因急性房角关闭合并白内障经局部及全身降眼压治疗眼压控制不佳,房角检查粘连≥180°行超声乳化白内障吸除加人工晶体植入联合小梁切除手术。B组19眼因急性房角关闭合并白内障患者经局部及全身降眼压治疗眼压控制在21mmHg以下,房角检查粘连﹤180°的眼行单纯超声乳化白内障吸除加人工晶体植入手术。C组:34只眼因慢性闭角型青光眼合并白内障,行超声乳化白内障吸除加人工晶体植入联合小梁切除手术。手术后分别对3组的视力、眼压、中央前房深度进行评估。[结果]术后所有患者视力均有不同程度提高;术后眼压控制良好84只眼,其余1只眼手术后3d眼压升高,UBM检查诊断为恶性青光眼再行玻璃体切割手术后眼压得到控制。[结论]对于发病后房角开放﹥180°的闭角型青光眼患者可单纯行白内障超声乳化摘除术及可折叠人工晶状体植入;青光眼合并白内障行联合术大多能有效的降低眼压提高视力,但是术后早期需住院观察。[Objective]To study the surgical treatment of the two angle-closure glaucoma with cataract compared the clinical efficacy.[Methods]Angle-closure glaucoma in patients with senile cataract were 78 cases（85 eyes）.Group A were 32 eyes with acute angle-closure cataract intraocular pressure reduction by local and systemic treatment of poorly controlled intraocular pressure,angle check the adhesion ≥ 180° line than phacoemulsification plus intraocular lens implantation and trabeculectomy surgery.Group B were acute angle-closure in 19 eyes with cataract patients after treatment of local and systemic control of intraocular pressure lowering intraocular pressure below 21mmhg,check the adhesion angle ﹤180° of the eye with simple addition phacoemulsification plus intraocular lens implantation.Group C were 34 eyes of chronic angle-closure glaucoma and cataract,phacoemulsification cataract suction plus intraocular lens implantation combined trabeculectomy.he visual acuity,intraocular pressure,central anterior chamber depth in three groups were assessed after surgery.[Results]All patients＇ visual acuity were improved;84 eyes＇ IOP were well controlled,and the remaining one eye had intraocular pressure,intraocular pressure of glaucoma under control after vitrectomy by UBM diagnosis.[Conclusion]After onset open angle﹥ 180° of angle-closure glaucoma can be a simple cataract phacoemulsification and foldable intraocular lens implantation;combined glaucoma and cataract surgery is most effective in reducing intraocular pressure and improving vision,but hospitalized observation is still needed after surgery.

关 键 词：闭角型青光眼合并白内障 超声乳化术 小梁切除术 

分 类 号：R775[医药卫生—眼科] R766.1[医药卫生—临床医学]