穿透性Schlemm管成形联合晶状体摘出术治疗闭角型青光眼  

Penetrating canaloplasty of Schlemm’s canal combined with lens extraction for the treatment of angle-closure glaucoma

作　　者：陈聪 常新奇 张祎草[1] 王卫群[2] Chen Cong;Chang Xinqi;Zhang Yicao;Wang Weiqun(Department of Glaucoma.Anyang Eye Hospital,Anyang 455000,China;Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]安阳市眼科医院青光眼科,安阳455000 [2]郑州大学第一附属医院眼科,郑州450052

出　　处：《中华眼外伤职业眼病杂志》2022年第4期292-297,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

摘　　要：目的评价穿透性Schlemm管成形术联合晶状体摘出术治疗闭角型青光眼的效果。方法回顾性分析安阳市眼科医院2020年1月至2021年5月穿透性Schlemm管成形联合晶状体摘出术治疗闭角型青光眼34例(34眼)的临床资料。观察术前、术后眼压及视力、手术成功率及并发症。随访时间为6个月。结果术前眼压为(38.21±10.93)mmHg(1 mmHg=0.133 kPa),术后3 d、1个月及6个月的眼压依次为(14.63±5.34)mmHg、(16.72±6.48)mmHg及(15.56±4.24)mmHg,术后均低于术前(t=8.35、8.52及8.46,均P<0.001)。术后6个月:视力提高1行以上者25眼(73.53%),维持术前视力者5眼(14.71%),视力下降者4眼(11.76%);基本痊愈率为94.12%(32/34)、痊愈率为88.24%(30/34)。手术并发症包括前房积血7眼(20.59%)、浅前房3眼(8.82%)、滤过口阻塞2眼(5.88%)、一过性高眼压12眼(35.29%)。结论穿透性Schlemm管成形联合晶状体摘出术是治疗闭角型青光眼比较安全有效的手术方式,其短期降眼压效果显著。Objective To evaluate the efficacy of penetrating canaloplasty of Schlemm’s canal combined with lens extraction in the treatment of angle-closure glaucoma.Methods The clinical data of 34 eyes of 34 patients with angle-closure glaucoma from Jan.2020 to May 2021 in Anyang Eye Hospital were analyzed retrospectively.All cases underwent penetrating canaloplasty of Schlemm’s canal combined with lens extraction.Preoperative and postoperative intraocular pressure,visual acuity,the success rate of surgery and complications were observed.The follow-up time was 6 months.Results The intraocular pressure was(38.21±10.93)mmHg(1 mmHg=0.133 kPa)preoperatively,that at 3 days,1 month and 6 months after operation were(14.63±5.34)mmHg,(16.72±6.48)mmHg and(15.56±4.24)mmHg,respectively.All of them were lower than those before surgery(t=8.35,8.52,8.46;all P<0.001).At 6 months after operation,the visual acuity of 25 eyes(73.53%)improved more than one line,maintained in 5 eyes(14.71%),and decreased in 4 eyes(11.76%).The favour rate was 94.12%(32/34)and the complete cure rate was 88.24%(30/34).Surgical complications included anterior chamber hemocele in 7 eyes(20.59%),shallow anterior chamber in 3 eyes(8.82%),filter obstruction in 2 eyes(5.88%)and transient ocular hypertension in 12 eyes(35.29%).Conclusion Penetrating canaloplasty of Schlemm’s canal combined with lens extraction is a safe and effective surgical method for angle-closure glaucoma,it has a remarkable short-term effect on lowering intraocular pressure.

关 键 词：青光眼 闭角型 成形术 管 Schlemm 摘出术 晶状体 眼压 效果 手术 

分 类 号：R779.6[医药卫生—眼科]