结膜下角巩膜缘斜切口白内障摘除联合房角分离术的临床应用  

Effect of subconjunctivalimbus oblique incision combined with goniosynechialysis on primary angle-closure glaucoma patients with cataract

作　　者：韩芳[1] 杨军[1] 田润[1] 雷霍[1] 

机构地区：[1]云南省第一人民医院眼科(昆明理工大学附属医院),云南省眼底病中心,昆明市650032

出　　处：《实用医学杂志》2016年第21期3578-3581,共4页The Journal of Practical Medicine

摘　　要：目的:探讨结膜下角巩膜缘斜切口白内障摘除联合房角分离术治疗闭角型青光眼合并白内障在基层医院的临床应用效果。方法:对80例(90眼)闭角型青光眼合并白内障患者分为急性闭角型青光眼组和慢性闭角型青光眼组,采用结膜下角巩膜缘斜切口白内障摘除联合房角分离术,观察术后视力、眼压、前房深度、房角及并发症情况。结果:80例(90眼)患者术后视力明显提高。术后眼压降低,术前急闭组平均眼压(30±8)mm Hg,术后1个月为(14±5)mm Hg;慢闭组术前平均眼压(25±7)mm Hg,术后1个月为(16±7)mm Hg,差异有显著统计学意义(P<0.01)。术后房角开放范围增大,中央前房深度显著加深。术前急闭组平均中央前房深度(1.5±0.23)mm,术后1月(2.48±0.33)mm,术前慢闭组平均中央前房深度(1.6±0.25)mm,术后1月(2.47±0.32)mm,差异有显著统计学意义(P<0.01)。结论 :结膜下角巩膜缘斜切口白内障摘除联合房角分离术能有效治疗闭角型青光眼合并白内障患者,适合在基层医院推广应用。Objective To investigate the clinical effect of subconjunctivalimbus oblique incision（SCOLI） combined with goniosynechialysis on primary angle-closure glaucoma （PACG） patients with cataract in primary hosipital. Methods 80 cases （90 eyes） of primary angle-closure glaucoma patients with cataract were divided into the acute PACG group and the chronic PACG group. They received SCOLI combined with goniosynechialysis. The intraocular pressure （IOP） before and after operation, best corrected visual acuity, central anterior chamber,the change of anterior chamber angle and complication were detected at 1 day, 1 week and 1 month postoperation. Results The visual acuity was significantly improved after surgical treatment （P 〈 0.01）. The postoperative IOP in both the acute and the chronic group markedly decreased from （30 ± 8） mmHg to （14 ± 5） mmHg in APACG group, and from （25 ± 7） mmHg to （16 ± 8） mmHg in CPACG group. The anterior chamber angles were observed opened widely in all patients. The central anterior chamber was deepened from （1.5 ± 0.23） mm to （2.48 ± 0.33） mm in APACG group, and from （1.6 ± 0.25） mm to （2.47 ± 0.32）mm CPACG at 1 month post-operation, Conclusion The surgical method of SCOLI combined with goniosynechialysis was suggested as an effective and safe management choice for PACG patients with cataract in primary hospitals.

关 键 词：青光眼 结膜下角巩膜缘斜切口 房角粘连分离术 闭角型 

分 类 号：R779.6[医药卫生—眼科]