原发性闭角型青光眼合并白内障手术方式临床评价

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英文篇名：Clinical assessment of the operation method of primary angle closure glaucoma combined with cataract 作者：张自艳 英文作者：Zhang Ziyan;Department of Ophthalmology,Chuxiong State Hospital of Yunnan; 关键词：青光眼 ; 闭角型 ; 白内障 英文关键词：Glaucoma;;Goniosynechialysis;;Cataract 中文刊名：XCYS 英文刊名：Chinese Community Doctors 机构：云南楚雄州医院眼科; 出版日期：2014-10-28 16:02 出版单位：中国社区医师 年：2014 期：v.30 语种：中文; 页：XCYS201430063 页数：2 CN：30 ISSN：22-1405/R 分类号：104-105

摘要

目的:探讨超声乳化白内障吸除人工晶体植入联合房角分离、虹膜周边切除、小梁切除术治疗急慢性闭角型青光眼合并白内障的疗效。方法:将38例48眼青光眼合并白内障患者根据房角粘连情况分为3组:房角粘连关闭≤180°12眼,采用超乳联合房角分离术;180°<房角粘连关闭≤270°20眼,采用超乳联合房角分离、虹膜周边切除术;房角粘连关闭>270°16眼,采用超乳、房角分离联合小梁切除术(简称三联)。随访3个月~5年,对比术前、术后的视力、眼压、前房深度及前房角变化。结果:29眼急性闭角型青光眼和19眼慢性闭角型青光眼术后眼压控制在正常范围,视力恢复良好;6只慢性闭角型青光眼房角粘连>2/3,术后近期眼压控制好,术后1.8~2年眼压再次增高,药物效果好,眼压控制在正常范围。结论:对于原发性闭角型青光眼合并白内障患者,根据房角关闭情况:房角粘连关闭≤180°,仅行超乳联合房角分离术;180°<房角粘连关闭<270°,超乳联合房角分离、虹膜周边切除术;房角粘连关闭>270°,超乳联合小梁切除术(三联术)可有效控制眼压,但仍需长期随访。
        Objective:To explore the curative effect of phacoemulsification and intraocular lens implantation combined with goniosynechialysis,peripheral iridectomy and trabeculectomy in the treatment of acute and chronic angle closure glaucoma with cataract.Methods:According to the corner adhesion situation,38 glaucoma patients with cataract with 48 eyes were divided into three groups.12 eyes were the corner adhesion close≤180°by using phaco joint corner separation;20 eyse were 180°270°by using super milk,goniosynechialysis combined with trabeculectomy(for short trigeminy).Follow up of 3 months to5 years,the changs of preoperative and postoperative visual acuity,intraocular pressure,anterior chamber depth and anterior chamber angle were compared.Results:The postoperative intraocular pressure of 29 acute angle closure glaucoma and 19 chronic angle closure glaucoma were controled in the normal range,and visual acuity recovered well.The adhesion corners of 6 chronic angle closure glaucoma were more than 2/3,and the postoperative recent intraocular pressure was controled well.After 1.8 to 2years,the intraocular pressure increased again;the drug effect was good;the intraocular pressure was controled in the normal range.Conclusion:For the patients with primary angle closure glaucoma combined with cataract,according to the corner adhesion situation,the corner adhesion close≤180° only was given phaco joint corner separation;180° 270°was given the super milk combined with trabeculectomy(triple surgery).That can effectively control the intraocular pressure,but still need long term follow-up.

引文

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