改良瞳孔成形术在青光眼性瞳孔散大合并白内障手术中的应用  

Effect of phacoemulsification and trabeculectomy combined with modified pupilloplasty for patients suffered from acute attack of angle-closure glaucoma with large pupil and cataract

作　　者：吴仲新 仲明 朱萍[1] 朱国平[1] 封艳[1] 邓雨谷 周一琅 

机构地区：[1]浙江省海宁市人民医院眼科,海宁314400

出　　处：《中国眼耳鼻喉科杂志》2017年第6期395-398,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

基　　金：嘉兴市科技计划项目(2014AY21075)

摘　　要：目的分析改良瞳孔成形术在原发性闭角型青光眼急性发作后瞳孔散大合并白内障患者手术中的应用效果。方法原发性闭角型青光眼急性发作后瞳孔散大合并白内障患者42例(44眼),全部病例均行白内障超声乳化联合小梁切除术,按术中瞳孔成形与否分为瞳孔成形术组与瞳孔未成形术组。对2组手术前后视力、眼压、瞳孔直径、并发症进行对比分析。结果 2组病例术后视力均有提高,眼压下降至正常范围。术后3个月,2组间视力、眼压比较差异具有统计学意义(P<0.05);并发症差异无统计学意义(P>0.05)。瞳孔成形术组术后瞳孔明显缩小,与瞳孔未成形术组相比差异有统计学意义(P<0.01)。结论对于虹膜萎缩瞳孔散大至5 mm以上的青光眼合并白内障患者,在青光眼白内障联合手术的同时行改良瞳孔成形术,可在有效控制眼压、提高视力的同时缩小瞳孔,是一种可供选择的手术方法。Objective To evaluate the effect of phacoemulsification and trabeculectomy combined with a modified pupilloplasty for patients suffered from acute attack of angle-closure glaucoma with large pupil and cataract. Methods All forty-four eyes from forty-two patients suffered from acute attack of angle-closure glaucoma with dilated pupil and cataract were enrolled to accept trabeculectomy combined with phacoemulsification. They were divided into pupilloplasty group and the control group. The postoperative best corrected visual acuity （BCVA）, intraocular pressure （IOP）, pupil diameter （PD） and complications of the two groups were compared. Results Both groups had significantly better BCVA and normal IOP postoperatively. The pupilloplasty group had significantly better BCVA and lower IOP than the control group （P 〈 O. 05）. There was no significant difference complications between the two groups （P 〉0.05）. Conclusions Phacoemulsification and trabeculectomy combined with modified pupilloplasty could be an optional way to manage patients suffered from acute angle-closure glaucoma and cataract with iris atrophy and pupil diameter larger than 5 ram.

关 键 词：青光眼 瞳孔散大 超声乳化吸除术 瞳孔成形术 

分 类 号：R779.6[医药卫生—眼科]