白内障超声乳化联合机械性房角分离治疗闭角型青光眼
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摘要
目的:观察前房角镜辅助下的机械性房角分离术联合超声乳化白内障摘除和IOL植入治疗原发性闭角型青光眼(PACG)合并白内障的疗效。方法:选取45例52眼房角镜下粘连性房角关闭≥180°的PACG合并白内障患者,接受前房角镜辅助下的机械性房角分离术联合超声乳化白内障摘除。术后随访6mo,观察并记录患者术前和术后1、2、3、6mo的最佳矫正视力、眼压、房角粘连范围,以及术中和术后并发症。结果:术前眼压为33.92±5.45mmHg,术后1、2、3、6mo眼压分别为15.40±2.67、15.65±2.65、15.57±2.50、16.17±2.65mmHg,术后眼压较术前均明显降低(均P<0.01)。结论:超声乳化白内障摘除联合前房角镜辅助下房角分离术对于PACG疗效确切。
AIM: To observe the effectiveness of gonioscopy-assisted mechanical goniosynechialysis combined with phacoemulsification and intraocular lens implantation in treatment of primary angle-closure glaucoma(PACG) with cataract.METHODS: Gonioscopy-assisted mechanical goniosynechialysis combined with phacoemulsification was performed in 52 eyes of 45 patients with PACG and cataract.The synechial angle closure is ≥180° by dynamic observation with gonioscop.All Patients received gonioscopy-assistance mechanical goniosynechialysis combined with phacoemulsification and intraocular lens implantation.The follow-up time after surgery was 6mo.Observe and record the best corrected visual acuity, intraocular pressure(IOP), range of angle-closure and complications 1mo, 2mo, 3mo, and 6mo after surgery.RESULTS: Preoperative mean IOP was 33.92±5.45mmHg and was 15.40±2.67, 15.65±2.65, 15.57±2.50, and 16.17±2.65 mmHg, 1mo, 2mo, 3mo, and 6mo after surgery, respectively.All of the postoperative decrease in IOP were significant(P<0.01).CONCLUSION: Gonioscopy-assisted mechanical goniosynechialysis combined with phacoemulsification is safe and effective for PACG with cataract.
AIM: To observe the effectiveness of gonioscopy-assisted mechanical goniosynechialysis combined with phacoemulsification and intraocular lens implantation in treatment of primary angle-closure glaucoma(PACG) with cataract.METHODS: Gonioscopy-assisted mechanical goniosynechialysis combined with phacoemulsification was performed in 52 eyes of 45 patients with PACG and cataract.The synechial angle closure is ≥180° by dynamic observation with gonioscop.All Patients received gonioscopy-assistance mechanical goniosynechialysis combined with phacoemulsification and intraocular lens implantation.The follow-up time after surgery was 6mo.Observe and record the best corrected visual acuity, intraocular pressure(IOP), range of angle-closure and complications 1mo, 2mo, 3mo, and 6mo after surgery.RESULTS: Preoperative mean IOP was 33.92±5.45mmHg and was 15.40±2.67, 15.65±2.65, 15.57±2.50, and 16.17±2.65 mmHg, 1mo, 2mo, 3mo, and 6mo after surgery, respectively.All of the postoperative decrease in IOP were significant(P<0.01).CONCLUSION: Gonioscopy-assisted mechanical goniosynechialysis combined with phacoemulsification is safe and effective for PACG with cataract.
引文
1 Tham CC,Kwong YY,Leung DY,et al.Phacoemulsification vs phacotrabeculectomy in chronic angle-closure glaucoma with cataract:complications.Arch Ophthalmol 2010;128(3):303-311
2胡宏阁,王钰清.超声乳化白内障吸出人工晶状体植入术联合房角分离术治疗闭角型青光眼合并年龄相关性白内障的疗效观察.眼科新进展 2016;36(6):569-571
3杨旭,龙波,刘灵琳,等.超声乳化联合前房角分离治疗伴白内障的青光眼.国际眼科杂志2016;16(1):144-146
4 Quigley HA,Broman AT.The number of people with glaucoma worldwide in 2010 and 2020.Br J Ophthalmol 2006;90(3):262-267
5冯希敏,祁颖,张凤妍,等.超声乳化人工晶状体植入联合房角分离术治疗急性原发性闭角型青光眼合并年龄相关性白内障患者的疗效分析.眼科新进展2016;8(8):767-770
6 Azuara-Blanco A,Burr JM,Cochran C,et al.The effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle-closure glaucoma (EAGLE):study protocol for a randomized controlled trial.Trials 2011;12:133
7 Hayashi K,Hayashi H,Nakao F,et al.Changes in anterior chamber angle width ang depth after intraocular lens implantation in eyes with glaucoma.Ophthalmology 2000;107:698-703
8 Rodrigues IA,Alaghband P,Beltran Agullo L,et al.Aqueous outflow facility after phacoemulsification with or without goniosynechialysis in primary angle closure:a randomised controlled study.Br J Ophthalmol 2017;101(7):879-885
9胡郑君,胡红梅,李婷.白内障超声乳化联合房角分离术治疗周边虹膜切除术后合并白内障.国际眼科杂志 2015;15(12):2099-2101
10 Teekhasaenee C,Ritch R.Combined phacoemulsification and goniosynechialysis for uncontrolled chronic angle closure glaucoma after acute angle closure glaucoma.Ophthalmology 1999;106:669-674
11韩霞,叶剑,王维光.白内障超声乳化联合房角粘连分离术治疗慢性闭角型青光眼.中国实用眼科杂志 2005;23(7):726-728
12 Shingleton BJ,Chang MA,Bellows AR,et al.Surgical goniosynechialysis for angle-closure glaucoma.Ophthalmology 1990;97:551-556
13葛坚,郭彦,刘奕志,等.超声乳化白内障吸除术治疗闭角型青光眼的初步临床观察.中华眼科杂志 2001;37(5):355-358
2胡宏阁,王钰清.超声乳化白内障吸出人工晶状体植入术联合房角分离术治疗闭角型青光眼合并年龄相关性白内障的疗效观察.眼科新进展 2016;36(6):569-571
3杨旭,龙波,刘灵琳,等.超声乳化联合前房角分离治疗伴白内障的青光眼.国际眼科杂志2016;16(1):144-146
4 Quigley HA,Broman AT.The number of people with glaucoma worldwide in 2010 and 2020.Br J Ophthalmol 2006;90(3):262-267
5冯希敏,祁颖,张凤妍,等.超声乳化人工晶状体植入联合房角分离术治疗急性原发性闭角型青光眼合并年龄相关性白内障患者的疗效分析.眼科新进展2016;8(8):767-770
6 Azuara-Blanco A,Burr JM,Cochran C,et al.The effectiveness of early lens extraction with intraocular lens implantation for the treatment of primary angle-closure glaucoma (EAGLE):study protocol for a randomized controlled trial.Trials 2011;12:133
7 Hayashi K,Hayashi H,Nakao F,et al.Changes in anterior chamber angle width ang depth after intraocular lens implantation in eyes with glaucoma.Ophthalmology 2000;107:698-703
8 Rodrigues IA,Alaghband P,Beltran Agullo L,et al.Aqueous outflow facility after phacoemulsification with or without goniosynechialysis in primary angle closure:a randomised controlled study.Br J Ophthalmol 2017;101(7):879-885
9胡郑君,胡红梅,李婷.白内障超声乳化联合房角分离术治疗周边虹膜切除术后合并白内障.国际眼科杂志 2015;15(12):2099-2101
10 Teekhasaenee C,Ritch R.Combined phacoemulsification and goniosynechialysis for uncontrolled chronic angle closure glaucoma after acute angle closure glaucoma.Ophthalmology 1999;106:669-674
11韩霞,叶剑,王维光.白内障超声乳化联合房角粘连分离术治疗慢性闭角型青光眼.中国实用眼科杂志 2005;23(7):726-728
12 Shingleton BJ,Chang MA,Bellows AR,et al.Surgical goniosynechialysis for angle-closure glaucoma.Ophthalmology 1990;97:551-556
13葛坚,郭彦,刘奕志,等.超声乳化白内障吸除术治疗闭角型青光眼的初步临床观察.中华眼科杂志 2001;37(5):355-358