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

Preliminary clinical study on the management of angle-closure glaucoma by phacoemulsification with foldable posterior chamber intraocular lens implantation

目的 初步观察透明角膜切口超声乳化白内障吸除联合后房型折叠式人工晶状体植入术治疗合并白内障的闭角型青光眼的疗效。方法 回顾分析 1997年 5月至 2 0 0 0年 1月 ,收住本院青光眼病区资料完整的 42例 (4 7只眼 )闭角型青光眼 ,其中 2 6只眼为原发性急性闭角型青光眼 ,12只眼为原发性慢性闭角型青光眼 ,5只眼为继发性急性闭角型青光眼 ,4只眼为继发性慢性闭角型青光眼 ,患者均有不同程度的晶状体混浊。患者入院后均行透明角膜切口超声乳化白内障吸除联合后房型折叠式人工晶状体植入术。随访时间 6个月至 3年 ,平均 (18 40± 9 5 1)个月。结果 术后随访眼压为(11 99± 4 48)mmHg(1mmHg =0 133kPa) ,比术前用药后眼压 (2 5 47± 18 43)mmHg明显降低 ,差异有显著性 (t =4 918,P <0 0 0 1)。中央前房深度由术前的 (1 6 9± 0 46 )mm ,增加到术后的 (2 2 8± 0 36 )mm ,两者比较差异有显著性 (t =7 738,P <0 0 0 1)。术后 41只眼 (87 2 % )最佳矫正视力均有不同程度提高。结论 透明角膜切口超声乳化白内障吸除联合后房型折叠式人工晶状体植入术 ,可有效治疗合并白内障的闭角型青光眼。

Objective To investigate the clinical results of phacoemulsification with foldable posterior chamber intraocular lens (PC IOL) implantation in the management of angle closure glaucoma with cataract. Methods Phacoemulsification with PC IOL implantation performed on 47 eyes (42 cases) with angle closure glaucoma and cataract was retrospectively studied, including 26 eyes with primary acute angle closure glaucoma, 12 eyes with primary chronic angle closure glaucoma, 5 eyes with secondary acute angle closure glaucoma and 4 eyes with secondary chronic angle closure glaucoma. Results After a mean postoperative follow up of (18 40 ±9 51) months, the intraocular pressure was reduced from a preoperative mean of (25 47±18 43) mm Hg to a postoperative mean of (11 99±4 48) mm Hg ( t =4 918, P <0 001). The mean anterior chamber depth was (1 69±0 46) mm preoperatively and (2 28±0 36) mm postoperatively ( t =7 738, P <0 001) . The best corrected visual acuity was improved in 41 of 47 eyes (87 2%). Conclusion Phacoemulsification with posterior chamber foldable intraocular lens implantation can be a good alternative in treating angle closure glaucoma with cataract.