小梁切除联合小切口白内障摘除人工晶状体植入术疗效观察

The therapeutic results for trabeculectomy combined with small incision cataract extraction and intraocular lens implantation

目的探讨小梁切除联合小切口白内障摘除人工晶状体植入术的临床疗效。方法对26例31眼闭角型青光眼合并白内障患者行小梁切除联合小切口白内障摘除人工晶状体植入术,术后对视力、眼压、结膜滤过泡、并发症等情况观察,术后随访6～27月,平均3个月。结果术前平均眼压25.64±4.23mmHg,术后最终平均眼压13.68±3.7OmmHg,<0.0l;术后最终矫正视力0.2～1.0者27眼,0.1～0.15者3眼,0.02者1眼;术后早期并发症:角膜水肿及弹力层皱褶5眼,脉络膜脱离l眼,前房及瞳孔区纤维渗出6眼;晚期并发症:瞳孔欠圆7眼,人工晶状体夹持2眼,后发障4眼。结论小梁切除联合小切口白内障摘除及人工晶状体植入术治疗闭角型青光眼合并白内障患者,具有有效控制眼压、恢复视力,并发症少等效果。

Objective To investigate the therapeutic results for trabeculectomy combined with small incision cataract extraction and intraocular lens implantation. Methods 31 eyes (25 cases) of angle-closure glaucoma and cataract were received trabeculectomy combined with small incision cataract extraction and intraocular lens implantation. Post-operative visual acuity, intraocular pressure (IOP), filtration bleb and complications were observed. Follow-up periods were 6 to 27 months, averaged 3 months. Results The average IOP were reduced from (25.64±4.23) mmHg pre-operatively to (13.68±3.70) mmHg post-operatively. Best-corrected visual acuity were 0.2～1.0 in 27 eyes, 0.1～0.15 in 3 eyes, 0.02 in 1 eye after operation. Early complications included corneal edema and folds of corneal Descemet's membrane in 5 eyes, choroids detachment in 1 eye, formation of fibrous membrane in pupil area and anterior chamber in 6 eyes. Later complications included: pupil deformation in 7 eyes, intraocular lens captured in 2 eyes, after-cataract 4 eyes. Conclusion Treating patients of angle-closure glaucoma and cataract with trabeculectomy combined with small incision cataract extraction and intraocular lens implantation had better results of controlling IOP, postoperative VA and less complications.