白内障超声乳化吸除治疗原发性闭角型青光眼合并白内障观察  

Clinical observation of phacoemulsification treatment for primary angle-closure glaucoma complicated with cataract

作　　者：李春玲[1] 

机构地区：[1]辽宁中医药大学附属第四医院眼科,沈阳110101

出　　处：《中国实用眼科杂志》2012年第2期156-159,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 探讨白内障超声乳化吸除联合后房型人工晶状体植入治疗原发性闭角青光眼合并白内障的临床疗效.方法 同顾分析26例30只眼原发性闭角型青光眼合并白内障的患者,单纯行白内障超声乳化吸除人工晶状体植入术,观察手术前后视力,前房深度,房角及眼压的变化情况.术后随访12～ 24个月.结果 除1例有黄斑囊样变性,视力无提高外,其余患者术后视力均有不同程度提高.最佳矫正视力达0.1～0.4者10只眼（33.3％）,0.5～0.8者18只眼（60％）,大于1.0者2只眼（6.7％）.1只眼术后第一天出现暂时性眼压升高,给予降眼压治疗,3d后降至正常.1例急性闭角型青光眼因术前眼压高,术后炎症反应重,出现虹膜后粘连及房角广泛粘连,眼压升高,药物治疗眼压控制不理想,半年后行小梁切除术,眼压降至正常.2只眼术后需局部用1种降眼压药,其余患者不用任何药物眼压均在13～18 mm Hg之间.所有患者术后中央前房加深,由术前平均（1.65±0.36） mm增加到术后（2.57±0.46） mm,房角关闭或粘连不同程度开放.主要并发症有轻度角膜水肿及虹膜炎症反应.结论 白内障超声乳化吸除联合后房型人工晶状体植入术能够不同程度加深前房,开放房角,有效降低眼压,提高患者视力,是治疗原发性闭角青光眼合并白内障的有效方法.Objective To explore the clinical curative effect of cataract phacoemulsification with artificial lens implantation for treatment of primary angle-closure glaucoma complicated with cataract.Methods Retrospective analyzed 26 patients of 30 eyes with primary angle-closure glaucoma complicated with cataract.The phacoemulsification with IOL implantation was performed.Visual acuity,anterior chamber depth,the change of the angle and intraocular pressure were observed before and after operation.Follow-up was for 12 to 24 months. Results Visual acuity of all patients had different improvement except 1 case had no improvement due to cystic macular degeneration.The best corrected visual acuity （BCVA） was 0.1-0.4 in 10 eyes （33.3%）,0.5-0.8 in 18 eyes （60%）,the greater than 1.0 in 2 eyes （6.7%）.Temporary intraocular pressure （IOP） increased in 1 eye on the first day after surgery and backed to normal three days later after lower intraocular pressure eye drop treatment was given.One case had high intraocular pressure because the severe inflammatory response that caused iris adhesion and extensive adhesion to angle,that could not controlled by medication,and half years later received another trabeculectomy,then the IOP dropped to normal.Two eyes required eye drop to control the IOP,all other patients with IOP between 13 to 18 mmHg without any drugs. The central anterior chamber deepened from 1.65 ＋/-0.36mm preoperatively to2.57＋/-0.46mm postoperatively,the angle opened at different degrees.The main complications were mild corneal edema and iris inflammation. Conclusions Cataract phacoemulsification with IOL implantation can deepen anterior chamber,open angle,reduce intraocular pressure effectively.It is effective treatment method for primary angle-closure glaucoma complicated with cataract and to provide better vision for patients.

关 键 词：白内障超声乳化 人工晶状体 青光眼 白内障 眼压 

分 类 号：R775.2[医药卫生—眼科]