双切口小梁切除联合超声乳化人工晶状体植入术治疗青光眼合并白内障
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Double incision trabeculectomy combined with phacoemulsification and intraocular lens implantation for glaucoma complicated with cataract
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    摘要:

    目的:探讨双切口小梁切除联合超声乳化人工晶状体植入三联手术治疗青光眼合并白内障的效果。

    方法:选取我院2014-06/2016-01期间收治的急慢性闭角型青光眼合并白内障患者36例40眼,所有患者均采用双切口小梁切除联合超声乳化人工晶状体植入三联手术进行治疗。术后对所有患者均进行1mo随访,比较患者手术前后的视力、前房深度、前房角开放范围、眼压,同时观察患者的术后滤过泡情况以及术中、术后的并发症发生情况。

    结果:所有患者术前的眼压19~36(平均26.02±2.42)mmHg,术后1mo眼压11~22(平均13.62±4.38)mmHg,手术前后眼压比较差异有统计学意义(t=33.273,P<0.05)。术前视力<0.3者34眼(85.0%),术后视力>0.3者21眼(53%)。所有患者患眼在术后均形成良好滤过泡。36例患者术后的房角开放程度、前房角开放距离以及中央前房深度等均较术前有明显增加,差异具有统计学意义(t=5.832、5.924、33.293,P<0.05)。术后7眼出现角膜轻度水肿,均在术后3d内消失; 1眼在虹膜切除时出血,2d后被吸收; 4眼出现人工晶状体表面及前房纤维素渗出,术后6d内吸收,无其他严重并发症情况出现。

    结论:双切口小梁切除联合超声乳化人工晶状体植入三联手术治疗青光眼合并白内障能够有效改善患者的视力,并且能够较好地控制患者术后的眼压。

    Abstract:

    AIM:To investigate the effect of double incision trabeculectomy combined with phacoemulsification and intraocular lens implantation for the treatment of glaucoma complicated with cataract.

    METHODS:Selected 36 patients(40 eyes)with acute or chronic angle-closure glaucoma and cataract in our hospital from June 2014 to January 2016 were treated with double incision trabeculectomy combined phacoemulsification and intraocular lens implantation. All patients were followed up for 1mo to observe preoperative and postoperative visual acuity, anterior chamber depth, scope of anterior chamber angle open and intraocular pressure. At the same time, we observed the patients' postoperative filtering bleb and intraoperative and postoperative complications.

    RESULTS: Intraocular pressure before treatment were between 19-36mmHg, the average was 26.02±2.42 mmHg, and after the treatment intraocular pressure was patients between 11-22mmHg, the average was 13.62±4.38 mmHg, preoperative and postoperative intraocular pressure had the obvious difference(t=33.273, P<0.05). Preoperatively 85.0%(32 cases, 34 eyes)was with vision less than 0.3, and 53%(19 cases, 21 eyes)after surgery with eyesight over 0.3. All of the eyes formed good filtering bleb after surgery. Scope of anterior chamber angle open, anterior chamber angle open distance and central anterior chamber depth after operation increased in 36 cases compared with preoperative(t=5.832, 5.924, 33.293, P<0.05). There were 7 eyes with mild edema of the cornea, all disappear within 3d after surgery; one eye with bleeding when the iris was cut and absorbed after 2d; 4 eyes with fibrin effusion on lens surface and anterior chamber and absorbed with 6d. There were not any other severe complication in this study.

    CONCLUSION: Double incision trabeculectomy combined with phacoemulsification and intraocular lens implantation for glaucoma with cataract can effectively improve the patient's vision, and can better control the intraocular pressure after surgery.

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段文静.双切口小梁切除联合超声乳化人工晶状体植入术治疗青光眼合并白内障.国际眼科杂志, 2017,17(3):544-546.

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  • 收稿日期:2016-10-29
  • 最后修改日期:2017-02-10
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  • 在线发布日期: 2017-02-27
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