超声乳化联合前房角分离术治疗白内障伴急性闭角型青光眼  

Phacoemulsification combined with goniosynechialysis in the treatment of cataract with acute angle-closure glaucoma

作　　者：贺永毅[1] 文勇[1] 

机构地区：[1]成都市第六人民医院眼科,成都610051

出　　处：《中华眼外伤职业眼病杂志》2016年第7期514-517,共4页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的：观察超声乳化吸出联合前房角分离术治疗白内障伴急性原发性闭角型青光眼的临床疗效。方法以2010年2月至2014年1月我科收治的54例（54眼）白内障伴急性原发性闭角型青光眼为研究对象，所有患眼均接受晶状体超声乳化吸出联合前房角分离术治疗。比较其治疗前后视力、眼压、前房深度、前房角分级，分析该手术方式的临床效果。结果术后6个月较术前视力有显著改善（P＜0．05），仅2眼因伴有老年性黄斑病变而视力恢复不佳。术后1 d眼压为（13．22±3．44）mmHg（1 mmHg＝0．133 kPa），术后1个月眼压为（13．87±1．11）mmHg，术后3个月和6个月眼压分别为（13．81±0．97）mmHg 和（13．07±1．05）mmHg。术后6个月中央前房深度及周边前房深度分别为（3．53±0．32）mm和（3．91±0．14）mm，均显著高于术前（P＜0．05）。术后前房角分级较术前改善显著（ P＜0．05）。6眼出现角膜水肿，4眼出现前房炎症反应及虹膜纤维素样渗出，2眼浅前房，3眼瞳孔人工晶状体粘连。结论超声乳化吸出联合前房角分离治疗急性原发性闭角型青光眼安全有效，能显著增加前房深度，改善前房角开放程度，提高视力并降低眼压。Objective To observe the clinical efficacy of phacoemulsification combined with goniosynechialysis for cataract patients with acute primary angle-closure glaucoma .Methods From February 2010 to January 2014 , 54 eyes of 54 cases with cataract and acute primary angle-closure glaucoma admitted to our department were selected in this study .All patients received phacoemulsification combined with goniosynechialysis .The visual acuity , intraocular pressure , anterior chamber depth and angle changes before and after the treatment were compared .The clinical effects of this surgical approach were analyzed .Results The visual acuities 6 months after the surgery were significantly better than those before the surgery （ P〈0.05）, and only two eyes with age-related macular diseases had poor visual acuities less than 0.1.One day after the surgery, the intraocular pressure was （13.22 ±3.44） mmHg （1 mmHg=0.133 kPa）.One month after the surgery, the intraocular pressure was （13.87 ±1.11） mmHg.The intraocular pressure of three and six months after surgery were （13.81 ±0.97）mmHg and（13.07 ±1.05）mmHg respectively.Six months after the surgery, the central and peripheral anterior chamber depth were （3.53 ±0.32） mm and （3.91 ± 0.14）mm respectively, both were evidently higher than those before the surgery （P〈0.05）.The angle grading after the surgery were improved remarkably compared with the preoperative one （P〈0.05）.Corneal edemas occured in six eyes , and anterior chamber inflammation and iris fibrinoid exudations occured in four eyes.The anterior chamber of two eyes were shallow .The intraocular lens were adhered to pupil in three eyes.Conclusion Phacoemulsification combined with goniosynechialysis is safe and effective for angle -closure glaucoma .This kind of combined surgery can obviously increase the depth of the anterior chamber ,＆nbsp;improve the openness of angle , improve the vision and reduce the intraocular pressure .

关 键 词：青光眼 闭角型 超声乳化吸出术 白内障 前房角分离术 

分 类 号：R779.6[医药卫生—眼科]