白内障超声乳化联合人工晶状体植入术治疗原发性闭角型青光眼合并白内障临床疗效观察  

Clinical effect of phacoemulsification combined with intraocular lens implantation in management of primary angle-closure glaucoma with cataract

作　　者：李晓鹏[1] 高建伟[2] 王爽[1] 李彦[1] 刘静[1] 

机构地区：[1]新乡医学院第三附属医院眼科,河南新乡453003 [2]焦作煤业集团有限责任公司中央医院眼科,河南焦作454000

出　　处：《新乡医学院学报》2015年第2期169-170,174,共3页Journal of Xinxiang Medical University

摘　　要：目的评价白内障超声乳化联合人工晶状体植入术治疗合并白内障的原发性闭角型青光眼的安全性和临床疗效。方法收集合并白内障的原发性闭角型青光眼患者41例（52眼）,其中21例（28眼）行白内障超声乳化联合人工晶状体植入术（治疗组）,20例（24眼）行周边虹膜切除术（常规组）。对2组患者术后随访6个月,观察手术前后患者视力、眼压及抗青光眼药物使用量情况。结果 2组患者术后视力比较差异无统计学意义（P〉0.05）。术后随访6个月,治疗组患者均眼压≤21 mm Hg（1 mm Hg=0.133 k Pa）,平均眼压较术前降低（13.6±1.3）mm Hg,降压幅度达55.4%;常规组患者眼压≤21 mm Hg者18眼,21~30 mm Hg者6眼,平均眼压较术前降低（10.5±1.5）mm Hg,降压幅度达38.7%,2组比较差异有统计学意义（P〈0.05）。治疗组患眼术后无需应用抗青光眼药物,常规组患眼平均应用抗青光眼药物为（5.0±0.3）m L。结论白内障超声乳化联合人工晶状体植入术较常规抗青光眼手术更能有效降低眼压,减少术后抗青光眼药物使用量,是原发性闭角型青光眼合并白内障患者安全有效的治疗途径。Objective To evaluate the efficacy and safety of phacoemulsification plus intraocular lens implantation in the management of primary angle-closure glaucoma with cataract. Methods Forty-one patients（ 52 eyes） with primary angleclosure glaucoma with cataract were analyzed. Twenty-one patients（ 28 eyes,modified treatment group） were given phacoemulsification plus intraocular lens implantation. Twenty patients（ 24 eyes,convention treatment group） were given laser iridotomy.The visual acuity,intraocular pressure（ IOP）,the dose of anti-glaucoma medications were observed preoperatively and postoperatively in the two groups. All cases were followed up for 6 months. Results There was no statistical difference in visual acuity postoperatively between the two groups（ P〉0. 05）. Followed-up for six months,the IOP of patients in modified treatment group was less than or equal to 21 mm Hg（ 1 mm Hg = 0. 133 k Pa）; compared with before operation,the average IOP decreased by（ 13. 6 ± 1. 3） mm Hg,the decreased extent was 55. 4%. In convention treatment group,the IOP was less than or equal to21 mm Hg in 18 cases,the IOP was 21- 30 mm Hg in six cases; compared with before operation,the average IOP decreased by（ 10. 5 ± 1. 5） mm Hg,the decreased extent was 38. 7%. There was statistical difference in the IOP and the decreased extent between the two groups（ P〈0. 05）. In modified treatment group,no patient used anti-glaucoma medications postoperatively,whereas in convention treatment group,mean dose of anti-glaucoma medications was（ 5. 0 ± 0. 3） m L. Conclusions Phacoemulsification plus intraocular lens implantation is effective and safe in patients with primary angle-closure glaucoma. It can decrease the IOP and reduce the dose of anti-glaucoma drug.

关 键 词：白内障超声乳化术 原发性闭角型青光眼 周边虹膜切除术 

分 类 号：R775.2[医药卫生—眼科]