玻璃体抽吸联合晶状体超声乳化吸除治疗白内障继发青光眼持续高眼压状态的疗效分析  

Effects of vitreous suction and lens phacoemulsification on sustained elevated intraocular pressure with glaucoma secondary to cataract

作　　者：董宝莹[1] 李志辉[1] 汤学付[1] 刘俐[1] 冯敏婷[1] 

机构地区：[1]广东省佛山市顺德第一人民医院眼科,528300

出　　处：《临床眼科杂志》2016年第1期28-30,共3页Journal of Clinical Ophthalmology

摘　　要：目的观察玻璃体抽吸联合晶状体超声乳化吸除治疗白内障继发青光眼持续高眼压状态的疗效。方法选取2014年2月至2015年6月我院眼科就诊的老年性白内障继发青光眼患者60例（65只眼）,分为对照组与观察组,对照组为经药物治疗,眼压控制在40 mm Hg以内的患者,采用晶状体超声乳化吸出联合人工晶状体植入术,共36例（38只眼）;观察组为经药物治疗3~5天,眼压不能控制,前房极浅的患者,采用玻璃体穿刺抽液后再行晶状体超声乳化吸除联合人工晶状体植入术,共24例（27只眼）。分别观察术前术后视力、眼压、前房深度,以及术中术后并发症发生情况。结果观察组术后眼压为（14.38±4.71）mm Hg,显著低于术前眼压（50.53±19.08）mm Hg（P〈0.01）;对照组术后眼压为（22.37±6.12）mm Hg,较术前（32.14±8.13）mm Hg显著下降（P〈0.01）;观察组术后眼压显著低于对照组（P〈0.01）。两组患者术前前房深度无统计学差异,术后前房深度均高于术前,且观察组显著高于对照组（P〈0.01）。观察组术后矫正视力大于0.4、0.4、0.3比例明显升高,而小于0.1、0.1比例明显降低（P〈0.05）,0.2比例无明显差异（P〉0.05）。两组术后并发症发生率无统计学差异（P〉0.05）。结论玻璃体抽吸联合晶状体超声乳化吸除治疗白内障继发青光眼患者持续高眼压状态的疗效较好,能够显著降低眼压、增大前房深度及增进视力,且并发症较少。Objective To investigate treatment effects of vitreous suction and lens phacoemulsification on sustained high intraocular pressure（ IOP） in 60 patients with glaucoma secondary to cataract.Methods Patients were enrolled between February 2014 and June 2015.Totally 65 eyes were studied.Patients were divided into 2 groups.While patients’ IOP could be effectively controlled（〈40 mm Hg） with medications（n=38）,only phacoemulsification was performed（ control group）.In those whose IOP could not be controlled after 3~5 days of medication（ treatment group; n=27）,vitreous suction was done in addition to phacoemulsification（ observe group）.Visual acuity,IOP,anterior chamber depth,and intraoperative complications were compared.Results Postoperative IOP was 14.38±4.71 mm Hg in observe group,which was significantly reduced when compared to pre-operative IOP（50.53 ± 19.08 mm Hg,P〈0.01）.Similar IOP reduction was observed in control group,but postoperative IOP in control group（22.37 ± 6.12 mm Hg） was relatively higher（P〈0.01）.Best corrected visual acuity improved in treatment group（P〈0.05）.Complications included incomplete capsulorhexis,fulminant epichoroidal hemorrhage,intraocular hemorrhage,posterior capsule rupture,vitreous prolapse.All these complications were very rare（n=1 for each type）,and there seemed no difference of the occurrence between the two groups.Conclusion Vitreous suction and lens phacoemulsification is an effective treatment for secondary glaucoma due to cataract.

关 键 词：玻璃体抽吸术 超声乳化 白内障 青光眼 高眼压 

分 类 号：R779.6[医药卫生—眼科]