原发性闭角型青光眼小梁切除术后行白内障超声乳化联合房角分离术的疗效分析  

The analysis of the effectiveness of phacoemulsification combined with goniosynechialysis for primary angleclosure glaucoma after trabeculectomy

作　　者：刘励[1] 林胤[1] 陈本安[1] 陈清[1] 林琳[1] 

机构地区：[1]福州总医院九五临床部眼科,莆田351100

出　　处：《东南国防医药》2017年第1期51-53,共3页Military Medical Journal of Southeast China

摘　　要：目的探讨原发性闭角型青光眼(PACG)小梁切除术后再行白内障超声乳化联合房角分离术的临床疗效。方法 PACG小梁切除术后合并白内障的患者30例(32眼),行白内障超声乳化摘除加后房型人工晶状体植入联合房角分离术,记录手术前后视力、眼压、滤过泡形状、前房深度及房角形态等情况。结果超乳术后视力均有不同程度提高。术前眼压(22.7±8.3)mmHg,术后1周(16.7±7.3)mmHg,术后3个月(18.3±6.3)mmHg,术后1周及3个月时与术前相比差异均有统计学意义(P<0.05)。术后患眼的滤过泡形态与术前相同。中央前房深度术前(1.85±0.51)mm,术后3个月(3.05±0.35)mm,术后前房加深(P<0.01)。与超乳术前相比,房角粘连处大部分开放。结论 PACG小梁切除术后再行超声乳化联合房角分离术,在改善视力的同时可以进一步降低眼压、加深前房、开放房角且不影响原滤过泡形态。Objective To evaluate the effectiveness of phacoemulsification combined with goniosynechialysis for primary angle-closure glaucoma（ PACG） after trabeculectomy. Methods Thirty patients（ 32 eyes） with cataract suffered from PACG who had trabeculectomy before,underwent phacoemulsificaiton combined with goniosynechialysis. It was recorded the visual acuity（ VA）,intra-ocular pressure（ IOL）,filtering bleb morphology,the depth of anterior chamber and angle morphology. Results The VA improved after the combined surgery. Peri-phacoemulsificaiton IOPs were（ 22. 7 ± 8. 3） mmHg（ pre-）,（ 16. 7 ± 7. 3） mmHg（ 1 week）and（ 18. 3 ± 6. 3） mmHg（ 3 months） respectively. The IOP was significantly lower after surgery（ P〈0. 05）. The filtering bleb morphology remained unchanged after surgery. The depth of anterior chamber were（ 1. 85 ± 0. 51） mm and（ 3. 05 ± 0. 35） mm before and3 month after surgery（ P〈0. 05）. The anterior angle was reopened in almost all patients. Conclusion Phacoemulsification combined with goniosynechialysis can improve VA and decrease IOP,deepen the anterior chamber and reopen the angle for patients with cataract after trabeculectomy for PACG.

关 键 词：青光眼 闭角型 小梁切除术 白内障 超声乳化 房角分离 

分 类 号：R779.6[医药卫生—眼科]