白内障超声乳化联合小梁切除术

Combined Cataract Phacoemulsification and Trabeculectomy

目的观察超声乳化白内障吸除人工晶状体植入联合小梁切除术的临床效果。方法回顾性总结本院自2002年1月～2004年6月间,收治的青光眼合并白内障施行超声乳化人工晶状体植入联合小梁切除术25例(26眼),观察手术前、后最佳矫正视力(best correct visual acuity,BCVA)、眼压及术后并发症的发生情况。结果术后随访3～12个月,全部患者术后视力均有不同程度提高,术前视力≥0.1者11例,术后视力≥0.1者20例,经χ~2检验,P<0.05,差异有显著性。术前平均眼压24.50±4.30 mmHg,术后3个月、6个月、2个月与术前眼压比较,t 检验,P<0.01,差异有显著性。术后并发症,角膜水肿7例,瞳孔区渗出3例,2例发生浅部脉络膜脱离,无其它严重并发症。结论超声乳化白内障吸除人工晶状体植入联合小梁切除术治疗青光眼并发白内障能提高视力,降低眼压,是一种安全、有效、便捷的手术方法,适用于青光眼合并成熟期及近成熟期白内障。

Purpose To observe the clinic efficacy of the combined procedure of phacoemulsification intraocular lens (IOL)implantation and trabeculectomy.Methods Retrospectively summarize 25 cases(26 eyes)with glaucoma concurrence with cataract in our hospital(Shanghai Second Medical University,Ruijin Hospital Luwan Branch)from January 2002 to June 2004.The visual acuity and the intraocular pressure before and after surgery were examined in detail,and complications after surgery were also evaluated.Results The visual acuity of all patients was improved during the 3 to 12 months'follow-up. There were 11 cases whose visual acuity before surgery are≥0.1,and after that,there were 20 cases.With X^2 test,P< 0.05,the outcomes were statistical significant.Before surgery the average intraocular pressure was 24.50±4.30 mmHg.The average postoperative intraocular pressure after 3 months,6 months and 12 months,obvious lower than that before surgery, with t test,the outcomes were also statistical significant.Complications after surgery included:cornea edema 7 cases, pupillary exudates 3 cases,shght choroids detachment 2 cases,and no other serious comphcafions.Conclusion The combined procedure of phacoemulsification IOL implantation and trabeculectomy is a safe,effective and practical surgical treatment for glaucoma concurrence with cataract,which recovers the potential vision and lowers the intraocular pressure,and applied in glaucoma concurrence with cataract of both mature stage and inanature stage.