原发性闭角型青光眼合并白内障的术式选择
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广东省医学科研基金(No.A2010754); 中山市科技局项目(No.2013ZA141)


Surgical selection of primary angle-closure glaucoma combined cataract
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Medical Research Foundation from Guangdong Province(No.A2010754); Science and Technology Department Project from Zhongshan City(No.2013ZA141)

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    摘要:

    目的:探讨原发性闭角型青光眼合并白内障的手术方式选择。

    方法:选取闭角型青光眼合并白内障患者90例96眼,根据房角粘连程度及病程长短,非随机选择施行超声乳化+人工晶状体植入术(Phaco+IOL)、超声乳化+人工晶状体植入联合虹膜周切手术(Phaco+IOL+PLI)、超声乳化+人工晶状体植入联合小梁切除术(Phacotrab+IOL),观察手术前后的视力、眼压、前房轴深、滤过泡,随访时间为1mo。

    结果:三种手术方式治疗青光眼合并白内障,术后视力均显著提高(P<0.05)、眼压明显降低(P<0.05),术后1wk; 1mo三组之间眼压比较无显著差异。

    结论:微切口透明角膜超声乳化及联合手术治疗青光眼手术是安全的。房角粘连<90°可行超声乳化联合人工晶状体植入; 90°<房角粘连为<180°行超声乳化联合人工晶状体植入+联合周边虹膜切除术; 如果病程长且房角粘连>180°,考虑行超声乳化联合人工晶状体植入+小梁切除术。

    Abstract:

    AIM: To explore the surgical choice of cararact combined angle-closure glaucoma between phacoemulsification and association.

    METHODS:In this study, 90 cases(96 eyes)with cararact combined angle-closure glaucoma were selected. Those were nonrandomly assigned into three groups by goniosynechia degree and disease coursing, and phacoemulsification with intraocular lens implant(Phaco+IOL), phacoemulsification with intraocular lens implant combined peripheral iridotomy(Phaco+IOL+PLI), and phacotrabeculectomy(Phacotrab+IOL)were non-randomly performed. Then preoperative and postoperative visual acuity, intraocular pressure(IOP), axial anterior chamber depth(AACD)and bleb were observed 1wk and 1mo.

    RESULTS:In three surgical types of cararact combined angle-closure glaucoma,postoperative visions were evidently enhanced(P<0.05), while IOPs were evidently reduced(P<0.05). There was no significant difference among three groups-postoperative IOP respectively on 1wk and 1mo.

    CONCLUSION: Phacoemulsification and combined operations by minimal invasive cornea treating glaucomaare safe. We perform Phaco+IOL in case of goniosynechia degree less than 90°, Phaco+IOL+PLI in case of goniosynechia degree between 90°~180°, Phacotrab+IOL in case of goniosynechia degree more than 180°.

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袁建枚,杨新怀,黄勤,等.原发性闭角型青光眼合并白内障的术式选择.国际眼科杂志, 2015,15(6):1078-1080.

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  • 收稿日期:2015-01-21
  • 最后修改日期:2015-05-18
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  • 在线发布日期: 2015-06-01
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