晶状体全脱位所致青光眼的手术治疗

Surgical treatment for glaucoma due to complete luxation of lens.

目的评价玻璃体切除联合晶状体超声粉碎及小梁切除术治疗晶状体全脱位所致青光眼的疗效。方法共收治9例（9眼）外伤性晶状体全脱位所致青光眼病例，这砦病例都具有以下共同特点：晶状体全脱位于玻璃体腔；瞳孔散大，前房消失；眼压在40mmHg以上（1mmHg=0．133kPa），而且药物治疗无效。术中先用玻璃体切除器切除玻璃体后，再用晶状体超声粉碎器将晶状体吸引至玻璃体腔中央行晶状体超声粉碎术，术毕作常规小粱切除术。结果术后视力提高到眼前数指者2眼，0．1～0．3者3眼，0．3以上者4眼，术后眼压15—20mmHg者5眼，2l，24mmHg者4眼，经滴降眼压滴眼液后，眼压降至20mmHg以下。结论玻璃体切除联合品状体超声粉碎及小梁切除术治疗晶状休全脱位所致青光眼，具有眼内组织损伤小，术后散光轻及并发症少等优点。

Objective To evaluate the clinical therapeutic effects of vitrectomy combined phacofragmentation with traboculectomy for glaucoma due to complete luxation of lens. Methods Vitrectomy was performed in 9 patients with traumatic glaucoma due to complete luxation of lens at first, then phaeofragmented the lens in vitreous cavity, at last trabeculectomy was followed. There were the common characters in these patients ： lens dislocation in vitreous cavity ; dilation of pupil and flat anterior chamber,intraocular pressures （lOP） was above 40 mmHg and drugs treatment were effectless. Results The postoperative visual acuity were counting fingers （CF） in 2 eyes, 0. 1-0.3 in 3 eyes, 〉 0.3 in 4 eyes. The postoperative IOP were 15-20 mmHg in 5 eyes, 20-24 mmHg in 4 eyes （ treatment by eye drops obtained the lOP below 20 mmHg）. Conclusion Vitrectomy combined phacofragmentation with traboculectomy for glaucoma due to complete luxation of lens has the advantages of little injurys in ocular tissues, light astigmatism and few postoperative complications.