超声乳化联合房角分离术治疗晶状体膨胀继发性闭角型青光眼疗效分析  

Therapeutic efficacy of phacoemulcification combined with intraocular lens implantation and goniosychialysis in patients with phacomorphic glaucoma

作　　者：王海波[1] 杨艳华 徐少凯[1] 林松[1] 张繁友[1] 

机构地区：[1]大连市第三人民医院眼科,116033 [2]辽宁省盘锦市,辽河油田总医院曙光医院,124109

出　　处：《中国实用眼科杂志》2013年第11期1471-1473,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨超声乳化白内障摘除人工晶状体植入联合房角分离术治疗晶状体膨胀继发性闭角型青光眼的临床效果。方法对2008年1月至2011年1月在大连市第三人民医院眼科已诊断为晶状体膨胀继发性闭角型青光眼的32例患者32只眼实施超声乳化白内障摘除人工晶状体植入联合房角分离术，术中钝性分离房角关闭的区域。超声生物显微镜和房角镜观察手术前后房角的变化，A超测量眼轴、晶状体的厚度以及术前术后前房深度的变化。对视力和眼压进行追踪观察，随访时间20～36个月。结果全部患者术后房角开放，前房较术前平均加深1．1mm，眼压平均下降（16．4±4．6）mmHg，术后观察有4只眼眼压有缓慢的升高，局部使用1种降眼压眼液即可将眼压控制在正常范围。30只眼（93．8％）视力有显著的提高。结论对于短时间内（≤10d）发生的晶状体膨胀继发性闭角型青光眼，超声乳化白内障摘除人工晶状体植入联合房角分离术是有效的治疗方法。Objective To evaluate the therapeutic efficacy of phacoemulicfication combined with intraocular lens implantation and goniosychialysis in treating phacomorphic glaucoma. Methods This study evaluated eyes that had phacoemulcification combined with IOL implantation and goniosychialy- sis to treat phacomorphic glaucoma. Intraocular pressure （IOP）, corrected distance visual acuity （CD- VA）, and anterior chamber depth （ACD） were measured preoperatively and postoperatively. The fol- low-up was 20-36 months. Results The mean IOP in the 32 eyes was 27.9±7.4mmHg （range 15 to 40 mmHg） preoperatively and 16.4±4.6mmHg （range 10 to 27 mmHg） 20-36 months postoperatively （P 〈0.001, paired t test）. Four eyes had a slow increase in lOP over the follow-up; however, re- sponded well to continued treatment with a 13-blocker or u-blocker. The postoperative IOP was signifi- cantly lower postoperatively （P 〈0.00, paired t test）. The improvement in CDVA was significant post- operatively. The CDVA was 0.4 or better in 20 eyes （62.5%）. Preoperatively, the ACD was shallow （mean 1.6±0.4mm） because of the swollen lens; the mean postoperative ACD was 2.7±0.2mm; the in- crease was statistically significant. Conclusions Phacoemulcification with IOL implantation and go- niosychialysis is effective in treating phacomorphic glaucoma.

关 键 词：晶状体膨胀 青光眼 超声乳化 房角分离术 

分 类 号：R775.3[医药卫生—眼科]