超声乳化吸出联合小梁切除术中做与不做周边虹膜切除的比较  

Comparison study of phacotrabeculectomy combined with or without peripheral iridectomy

作　　者：韩宇[1] 汤静[1] 蒲一民[1] 

机构地区：[1]四川省乐山市人民医院眼科,614000

出　　处：《中华眼外伤职业眼病杂志》2012年第2期94-97,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的比较超声乳化吸出人工晶状体植入联合小梁切除术中，同时做与不做周边虹膜切除术的手术效果。方法对32例（38眼）青光眼合并白内障手术回顾性分析。采用双切口晶状体超声乳化吸出、折叠式人工晶状体植入联合小梁切除术，分成做周边虹膜切除术（PI组）20眼，不做周边虹膜切除术（NoPI组）18眼，经Pentacam测量术前术后前房参数变化，比较两组在统计学上的差异，比较视力、眼压和并发症发生情况。随访12个月。结果术前、术后1周、1个月、3个月、6个月、12个月前房角角度、中央前房深度、上方周边前房深度两组间差异无统计学意义（P〉0．05）。两组术后12个月平均眼压均明显低于术前（P〈0．05），且两组间差异无统计学意义（t=0．04，P〉0．05）。术后1周矫正视力1〉0．3者34眼（89．5％），明显高于术前者4眼（10．5％）（P〈0．05），两组间术后矫正视力差异无统计学意义（P〉0．05）。术后早期并发症为角膜水肿和前房渗出，PI组前房少量积血1眼，NoPI组术后1d，1眼出现周边虹膜堵塞小梁滤口，经周边虹膜切除处理后恢复正常。余无严重并发症。结论超声乳化吸出、人工晶状体植人联合小梁切除术中，做与不做周边虹膜切除术治疗青光眼合并白内障的效果无明显差异，均具有提高视力、降低眼压、加深前房、手术并发症少的效果。Objective To compare therapeutic effects of the phacotrabeculectomy and intraocular lens implantation with and without peripheral iridectomy（PI）. Methods Retrospective analysis of 32 cases （38 eyes） glaucomatous patients with a coexisting cataract, patients randomized for PI in 20 eyes or no PI in 18 eyes during the combined two-site phacoemulsification, foldable intraocular lens implantatidn and trabecu- lectomy, The two groups were compared for visual acuity （VA）, intraocular pressure （IOP）, complication rates, and parameters variation of anterior chamber pre-and postoperative with Pentacam. followed for 12 months. Results There were no statistical differences in two groups for anterior chamber angle, central an- terior chamber depth, superior peripheral chamber depth in preoperative, 1 week, 1 month, 3 months, 6 months, 12 months postoperatively （P 〉 0.05 ）. The mean postoperative IOP lower than preoperative in both groups in 12 months after surgery （P 〈0.05 ） . There was no differences in two groups for mean postopera- tive introcular pressure in 12 months after surgery （t =0. 04 ,P 〉 0.05 ） . 1 week postoperatively, corrected visual acuity were better than 0. 3 （89.5 % ） in 34 eyes, the number was 4 eyes （10.5%） preoperation. There was no statistical differences in two groups （ P 〉 0. 05 ）. The postoperative early complieatirm was corneal edema and anterior chamber exudation, small amounts hyphema in one eye from the PI group, and one eye from the no PI group developed an iris incarceration into the internal sclerectomy site on postopera- tive day 1, returned to normal by peripheral iridectomy. No other significant complications. Conclusion Combined phacoemulsification, foldable intraocular lens implantation and trabeculectomy, peripheral iridectomy or no peripheral iridectomy were similiarly safe and effective in improve visual acuity, lower lOP, deepen anterior champber and less complication in patients with co-existing glaucoma and cataract.

关 键 词：晶状体超声乳化吸出术 小梁切除术 青光眼合并白内障 周边虹膜切除 PENTACAM系统 

分 类 号：R779.6[医药卫生—眼科]