持续高眼压下白内障青光眼联合手术中青光眼引流器的应用  

The clinical effect of Ex-Press glaucoma drainage device implantation combined with phacoemulsifi- cation for primary acute angle-closure glaucoma with cataract and persistent ocular hypertension

作　　者：刘杰 

机构地区：[1]新泰市中医院眼科,山东271200

出　　处：《中华眼外伤职业眼病杂志》2015年第6期415-418,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨Ex—Press青光眼引流器植入联合晶状体超声乳化吸出术治疗合并白内障的急性闭角型青光眼持续高眼压患者的临床效果和安全性。方法回顾性分析26例（30只眼）行Ex—Press青光眼引流器植入联合超声乳化手术治疗的合并白内障的急性闭角型青光眼持续性高眼压患者术前及术后各时间段的视力、眼压及并发症发生情况。结果所有患者均随访至1年，完全成功率为76．67％（23只眼），部分成功率23．33％（7只眼），总成功率100．00％。术前平均眼压为（32．19±9．12）mmHg（1mmHg=0．133kPa）。术后1周，1、2、3、6及12个月的平均眼压分别为（10．30±5．07）mmHg、（10．28±4．93）mmHg、（10．87±4．22）mmHg、（11．32±6．11）mmHg、（12．12±6．07）mmHg、（13．05±5．26）mmHg，手术后眼压均较术前低，差异有统计学意义（P〈0．05）。术后1周视力较术前提高，差异有统计学意义（Z=-4．19，P=0．000）。30只眼中2只眼出现少量前房积血，分别于术后4～7d吸收；4只眼出现一过性低眼压，8-10d后眼压〉6mmHg；1只眼出现渗出性脉络膜脱离，于术后14d复位。所有患者均未出现其他并发症。结论Ex-Press青光眼引流器植入联合晶状体超声乳化吸出术是治疗合并白内障的急性闭角型青光眼持续性高眼压的一种安全而有效的方法。Objective To investigate the clinical effects and safety of Ex-Press glaucoma drainage device implantation combined with phacoemulsification （E-P P） for primary acute angle-closure glaucoma （PAACG） with cataract and persistent ocular hypertension. Methods The data of 30 eyes of 26 patients of PAACG with cataract and persistent ocular hypertension were retrospectively analyzed, who received E-P P surgery. The visual acuity, intraocular pressure （IOP） and complications were observed. Results All pa- tients were followed up for 1 year. The complete success rate was 76.67% （23 eyes）, the partial success rate was 23.33% （7 eyes） , and the total success rate was 100.00%. The IOP before operation and 1 week, 1, 2, 3, 6 and 12 month after operation were （32.19± 9.12） , （ 10.30 ± 5.07 ） , （ 10.28 ± 4.93 ） , （ 10.87 ± 4.22）, （ 11.32 ± 6. 11）, （ 12.12± 6.07 ） and （ 13.05 ± 5.26） mmHg（ 1 mmHg = 0.133 kPa） respective- ly. Postoperative IOP was significantly decreased comparing with the preoperative one, and the difference was statistically significant （ P 〈 0.05 ）. The visual acuity one week after operation was significantly im- proved comparing with preoperative one （ Z = - 4. 19, P = 0. 000）. Early postoperative complications includ- ed hyphema in 2 eyes, transient low IOP in 4 eyes, and choroidal detachment in 1 eye, and all of those com- plications healed within 4 - 14 days. Conclusion Ex-Press glaucoma drainage device implantation combined with phacoemulsification is s＇,ffe and effective for the treatment of PAACG with cataract and persistent ocular hypertension.

关 键 词：白内障 青光眼 闭角型 急性 高眼压 持续性 晶状体超声乳化术 青光眼引流器 Ex—Press 

分 类 号：R779.6[医药卫生—眼科]