原发性闭角型青光眼合并白内障的术式选择  

Surgical selection of primary angle-closure glaucoma combined cataract

作　　者：袁建枚[1] 杨新怀[1] 黄勤[1] 覃旭方[1] 全婵娟[1] 

机构地区：[1]南方医科大学附属小榄医院眼科,中国广东省中山市528415

出　　处：《国际眼科杂志》2015年第6期1078-1080,共3页International Eye Science

基　　金：广东省医学科研基金(No.A2010754);中山市科技局项目(No.2013ZA141)~~

摘　　要：目的:探讨原发性闭角型青光眼合并白内障的手术方式选择。方法:选取闭角型青光眼合并白内障患者90例96眼,根据房角粘连程度及病程长短,非随机选择施行超声乳化+人工晶状体植入术(Phaco+IOL)、超声乳化+人工晶状体植入联合虹膜周切手术(Phaco+IOL+PLI)、超声乳化+人工晶状体植入联合小梁切除术(Phacotrab+IOL),观察手术前后的视力、眼压、前房轴深、滤过泡,随访时间为1mo。结果:三种手术方式治疗青光眼合并白内障,术后视力均显著提高(P<0.05)、眼压明显降低(P<0.05),术后1wk;1mo三组之间眼压比较无显著差异。结论:微切口透明角膜超声乳化及联合手术治疗青光眼手术是安全的。房角粘连<90°可行超声乳化联合人工晶状体植入;90°<房角粘连为<180°行超声乳化联合人工晶状体植入+联合周边虹膜切除术;如果病程长且房角粘连>180°,考虑行超声乳化联合人工晶状体植入+小梁切除术。AIM： To explore the surgical choice of cararact combined angle - closure glaucoma between phacoemulsification and association. METHODS： In this study, 90 cases （96 eyes） with cararact combined angle - closure glaucoma were selected. Those were nonrandomly assigned into three groups by goniosynechia degree and disease coursing, and phacoemulsification with intraocular lens implant （Phaco ＋ IOL）, phacoemulsification with intraocular lens implant combined peripheral iridotomy （ Phaco＋IOL＋PLI）, and phacotrabeculectomy （Phacotrab＋ IOL） were non- randomly performed. Then preoperative and postoperative visual acuity, intraocular pressure （ IOP）, axial anterior chamber depth （AACD） and bleb were observed lwk and 1 mo. RESULTS： In three surgical types of cararact combined angle- closure glaucoma, postoperative visions were evidently enhanced （P〈0.05）, while lOPs were evidently reduced （P〈 0.05）. There was no significant difference among three groups-postoperative lOP respectively on lwk and 1too. CONCLUSION： Phacoemulsification and combined operations by minimal invasive cornea treating glaucomaare safe. We perform Phaco ＋ IOL in case of goniosynechia degree less than 90°, Phaco ＋ IOL＋ PLI in case of goniosynechia degree between 90° ～ 180°, Phacotrab＋ IOL in case of goniosynechia degree more than 180°.

关 键 词：原发性闭角型青光眼 超声乳化 人工晶状体植入 联合手术 

分 类 号：R779.6[医药卫生—眼科]