Phacoemulsification,Intraocular Lens Implantation,Goniosynechialysis,and Pseudo-Pupilloplasty for Refractory Acute Primary Angle Closure with Atonic Dilated Pupil  

作　　者：Erqian Wang Ailing Bian Yang Zhang Shunhua Zhang 

机构地区：[1]Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China

出　　处：《Chinese Medical Sciences Journal》2022年第2期127-133,共7页中国医学科学杂志（英文版）

摘　　要：Objective To evaluate the efficacy and safety of prompt phacoemulsification,intraocular lens implantation,visco-goniosynechialysis,combined with pseudo-pupilloplasty for refractory acute primary angle closure(APAC)with atonic dilated pupil and to describe a feasible method of pupilloplasty.Methods A consecutive series of refractory APAC patients who had atonic dilated pupil and undergone prompt phacoemulsification combined with pseudo-pupilloplasty at our center were retrospectively analyzed.Pseudo-pupilloplasty referred to a method of pupilloplasty which included 4.5-mm capsulorhexis,postoperative opacification of anterior capsule residue,and ultimate pseudo-pupil formation.Preoperative and postoperative measurements included intraocular pressure(IOP),best corrected visual acuity(BCVA),and anterior chamber depth(ACD).Intraoperative and postoperative complications were documented.The process of pseudo-pupil formation was also observed.Results A total of 20 eyes of 19 APAC patients were followed up for 19.7±9.8 months.IOP was lowered from preoperative 44.0±9.8 mmHg to 15.5±2.6 mmHg at final visit(t=11.945,P<0.001).ACD was deepened from preoperative 1.77±0.21 mm to 3.40±0.20 mm at final visit(t=-27.711,P<0.001).Twelve of 20 eyes had residual angle synechiae,whereas only 3 eyes needed anti-glaucoma medications.No severe complication was observed.All eyes had pseudo-pupil gradually formed within 3 months,accompanied with the gradual improvement of BCVA from preoperative 1.18+0.55 to 0.58±0.22,0.26±0.09,0.11±0.09,and 0.11±.09 at postoperative day 1,month 1,month 3,and last visit.Conclusions Prompt phacoemulsification-goniosynechialysis is effective and safe for refractory APAC with atonic dilated pupil.Pseudo-pupilloplasty is a feasible procedure for pupil reconstruction.

关 键 词：acute primary angle closure PHACOEMULSIFICATION pupilloplasty 

分 类 号：R779.6[医药卫生—眼科]