不同手术方式治疗膨胀期白内障继发性青光眼持续高眼压的临床效果  

Clinical effect of different operation methods in treating expansion stage cataract secondary glaucoma continuous high intraocular pressure

作　　者：董宝莹[1] 李志辉[1] 汤学付[1] 段勇波[1] 

机构地区：[1]广东省佛山市顺德区第一人民医院眼科,广东佛山528300

出　　处：《中国当代医药》2016年第2期88-90,93,共4页China Modern Medicine

基　　金：广东省佛山市医学类科技攻关项目(2014AB002253)

摘　　要：目的探讨不同手术方式治疗膨胀期白内障继发性青光眼持续高眼压的临床效果。方法选取2014年2-12月在我院诊断为膨胀期白内障继发性青光眼,经最大剂量抗青光眼药物治疗2-3 d后眼压≥5.33 k Pa的持续高眼压患者,共22例22眼。随机分为两组,实验组行玻璃体穿刺抽液联合白内障超声乳化＋人工晶体植入术,共10例;对照组行前房穿刺联合白内障超声乳化＋人工晶体植入术,共12例。观察并比较两组患者术后视力、眼压、前房深度变化情况及手术并发症发生情况。结果所有患者经玻璃体抽吸或前房穿刺放液联合白内障超声乳化＋人工晶体植入术后视力、眼压、前房深度变化情况等均无改善,差异无统计学意义（P〉0.05）;玻璃体穿刺抽液组手术并发症发生率（20%）低于前房穿刺组（58.33%）,差异有统计学意义（P〈0.05）。结论白内障超声乳化＋人工晶体植入术中联合玻璃体穿刺抽液或前房穿刺均可降低膨胀期白内障继发性青光眼持续高眼压状态患者的眼压、提高视力,但前者更安全,可降低手术并发症的发生率。Objective To explore the clinical effect of different operation methods in treating expansion stage cataract secondary glaucoma continuous high intraocular pressure. Methods 22 continuous high intraocular pressure patients（22 eyes）,diagnosed as expansion stage cataract secondary glaucoma in our hospital and intraocular pressure more than5.33 k Pa after treated with maximal dosage anti-glaucoma agents for 2 to 3 days from February 2014 to December were selected.Patients were randomly divided into two groups.10 cases in experimental group were treated with vitreous puncture pumping fluid combined with cataract ultrasonic emulsification plus artificial lens implantation.12 cases in control group were treated with anterior chamber puncture combined with cataract ultrasonic emulsification plus artificial lens implantation.Postoperative eyesight,intraocular pressure,changes of anterior chamber depth and incidence of operation complications were observed and compared in two groups after operation. Results Postoperative eyesight,intraocular pressure,changes of anterior chamber depth of all patients improved after vitreous aspiration or anterior chamber puncture fluid combined with cataract ultrasonic emulsification plus artificial lens implantation,but there was no obvious difference compared with two groups（P〈0.05）.The operation complications incidence rate in vitreous puncture pumping fluid group was 20%,lower than that was 58.33% in anterior chamber puncture group,and the difference was statistical significance（P〈0.05）. Conclusion Both of cataract ultrasonic emulsification plus artificial lens implantation combined with vitreous puncture pumping fluid or anterior chamber puncture can reduce the expansion stage cataract secondary glaucoma continuous high intraocular pressure and enhance eyesight.But the former is more safety and can decrease the incidence rate of operation complications.

关 键 词：玻璃体抽吸 前房穿刺 晶状体超声乳化术 白内障继发青光眼 持续高眼压状态 

分 类 号：R775[医药卫生—眼科]