青光眼小梁切除术后极度浅前房的白内障手术  

Surgery for cataract with extremely shallow anterior chamber after trabeculectomy

作　　者：杜珊珊[1] 张凤妍[1] 刘旭辉[1] Du Shans han;Zhang Fengyart;Liu Xuhui(Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Henan ProvincialOphthalmic Hospital, Zhengzhou 450052, China)

机构地区：[1]郑州大学第一附属医院眼科河南省眼科医院,450052

出　　处：《中华眼外伤职业眼病杂志》2019年第2期96-100,共5页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的探讨青光眼小梁切除术后极度浅前房的白内障手术的效果。方法回顾性分析2017年1月至2018年3月收治青光眼小梁切除术后极度浅前房白内障5例(5眼)的临床资料。患眼滤过泡扁平或呈囊状,虹膜前后粘连,前房消失,晶状体完全白色浑浊,眼压高。均行睫状体平坦部玻璃体穿刺放液联合前房角分离术及晶状体超声乳化人工晶状体植入术:术后随访6?12个月。结果5例术中均顺利形成前房。术前最佳矫正视力为光感或手动,术后为0.2?0.4。术前平均眼压为(38. 80 ± 11.44)mnHg( 1 mmHg =0. 133 kPa),术后眼压明显降低,末次随访平均眼压为(15. 80 ±2.02)mmHg,与术前眼压相比差异有统计学意义(P<0.01)。术后前房明显加深,末次随访中央前房深度平均为(2.81 ±0.21 )mm,与术前相比差异有统计学意义(P <0.001 )。术后6个月,中央角膜内皮细胞平均丢失率为18.4%。术中术后均无严重并发症发生。结论青光眼小梁切除术后极度浅前房白内障可以通过此联合手术解除瞳孔阻滞,加深前房,降低眼斥.Objective To investigate the efficacy of surgery for cataract with extremely shallow anterior chamber after trabeculectomy. Methods The data of 5 eyes of 5 cases of cataract with extremely shallow anterior chamber after trabeculectomy from Jan. 2017 to Mar. 2018 were analyzed retrospectively. Preoperative manifestation of all cases were cystoid or flat filtering blebs, anterior and posterior synechia, disappeared anterior chamber, mature white lens and high intraocular pressure ( IOP). All patients underwent vitreous puncture and fluid releasing via the pars plana combined with goniosynechialysis, phacoemulsification and intraocular lens implantation. The patients were followed up for 6-12 months. Results The anterior chamber was formed in all 5 cases during operation. Preoperalive best corrected visual acuity were light perception or hand motion, and the postoperative visual acuity was 0. 2 - 0. 4. The mean preoperative IOP was (38. 80 ± 11.44) mmHg ( 1 mmHg =0. 133 kPa), and the mean postoperative IOP at the final visit was ( 15. 80 ± 2. 02 ) mmHg ( P < 0. 01 ). The difference of IOP was statistically significant between before and after operation. Anterior chamber disappeared before operation, and the mean postoperative central anterior chamber depth at the final visit was significantly increased to (2.81 ± 0. 21 ) mm (P <0.001 ). At 6 months after operation , the loss rate of corneal endothelial cells was 18. 4%. No severe complication occurred during and after operation. Conclusion The combined surgery for the treatment of cataract with extremely shallow anterior chamber after trabeculectomy can resolve pupillary block, deepen the anterior chamber and reduce IOP.

关 键 词：白内障 前房 浅 极度 青光眼 穿刺 玻璃体 

分 类 号：R779.6[医药卫生—眼科]