联合手术治疗晶状体半脱位继发青光眼的一年效果  

One year efficacy of combined surgical approaches in the treatment of secondary glaucoma due to lens subluxation

作　　者：陈琳[1] 王涛[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心眼科学与视觉科学北京市重点实验室,100730

出　　处：《眼科》2015年第4期250-253,共4页Ophthalmology in China

摘　　要：目的分析以白内障摘除联合人工晶状体(IOL)、张力环植入为主要手术方式的联合手术治疗晶状体半脱位继发青光眼的疗效。设计回顾性病例系列。研究对象2011年7月至2013年9月北京同仁眼科中心年龄(62.3±6.9)岁的晶状体半脱位继发青光眼患者12例。方法回顾患者手术前后的病历资料。所有患者均囊袋内植入IOL,超声乳化白内障摘除11例,白内障囊外摘除1例,张力环植入6例,联合黏弹剂房角分离7例,联合小梁切除术5例,联合术中经巩膜睫状体光凝1例,术中玻璃体水囊抽吸4例。术后平均随访(13.3±10.0)个月。主要指标视力、眼压、并发症。结果最后一次随访时,8/12例患者视力提高,平均提高(4.9±2.8)行;3/12例视力同术前。全部患者在未使用降眼压药物情况下眼压控制在21 mm Hg以下。术中、术后无严重并发症发生。结论本文的小样本量短期回顾性研究结果显示,以白内障摘除IOL植入联合张力环植入为主的联合手术是治疗晶状体半脱位继发青光眼的安全有效方法。Objective To analyze the effect of combined surgical approaches including cataract extraction, intraocular lens（IOL） and capsular tension ring（CTR） implantation as the main method for secondary glaucoma due to lens subluxation. Design Retrospective case series. Participants 12 patients aged 62.3±6.9 years old of secondary glaucoma due to lens subluxation from July 2011 to September 2013 in Beijing Tongren Hospital were included. Methods The medical records before and after the surgery were retrospectively analyzed. All cases were implanted IOL in the bag, 11 cases were performed phacoemulsification cataract extraction, one case extracapsular cataract extraction, 6 cases CTR, 7 cases goniosynechialysis with viscoelastic, 5 cases trabeculectomy, one case transscleral cyclophotocoagulation, 4 cases pars plana vitreous water bag aspiration during the surgery. The mean follow-up was 13.3±10.0 months. Main Outcome Measures Visual acuity, intraocular pressure（IOP） and complications. Result The visual acuity in last follow up was improved in 8/12 patients, the improved lines of visual acuity was 4.9±2.8. Unchange of visual acuity was in 3/8 patients. All patients（100%） got control of IOP（ 21 mm Hg） without drug at the final visit. No serious complications occurred during or after the operation. Conclusion The finding of small sample size and short-term follow-up of this article demonstrated that combined surgical approaches including cataract extraction combined with IOL and CTR implantation is safe and effective for secondary glaucoma of lens subluxation.

关 键 词：晶状体半脱位 继发性青光眼 张力环 

分 类 号：R779.6[医药卫生—眼科]