晶状体超声乳化联合前房角分离术的临床观察

Clinical observation of the combination of phacoemulsification and giniosynechialysis

目的观察晶状体超声乳化人工晶状体植入联合前房角分离术的临床效果。方法回顾分析2002年1月～2004年1月原发性闭角型青光眼合并白内障47例61眼,(其中前房角关闭≤180°者37眼,>180°者24眼),全部患者均有不同程度的晶状体浑浊。行透明角膜隧道切口晶状体超声乳化人工晶状体植入联合前房角分离术。结果47例(61眼)术后末次随访平均眼压(14.79±4.16)mmHg(1mmHg=0.133kPa),较术前用药后平均眼压(24.08±3.23)mmHg明显降低,差异具有统计学意义(t=13.86,P<0.001)。术后矫正视力均有不同程度的提高。中央前方深度由术前的(2.02±0.31)mm增加到术后的(2.91±0.28)mm,术后前房角均较术前增宽,术前关闭的前房角有不同程度地开放。结论晶状体超声乳化联合前房角分离术治疗原发性闭角型青光眼合并白内障能良好控制眼压和迅速提高视力。

Objective To evaluate the therapeutic effects of cornbined phacoemulsification and goniosynechialysis surgery with intraocularlens implantation. Methods 47 cases （61eyes） of primary angle-closure glaucoma （PACG） combined cataract were retrospectively studied from January 2002 to January 2004, including 37 eyes with range of closed-angle≤ 180°, 24 eyes with which 〉 180°. All the cases had cataract in different degrees. Combined phacoemulsification with corneal incision and goniosynechialysis surgery with intraocular lens implantation was performed on the eyes. Results In the last follow-up, the mean postoperative IOP of 47 cases （14.79 ±4.16） mmHg （1 mmHg= 0.133 kPa） was significantly decreased compared to preoperative IOP （24.08 ±3.23 ）mmHg （t = 13.86, P〈0.001）. The corrected visual acuity of postoperation in the cases were improved. The central anterior chamber depth was （2.02 ±0.31） mm preoperatively and （2.91 ±0.28） mm postoperatively （ t = 17.92, P 〈 0. 001 ）. All the chamber angles of postoperation were wider than that of preoperation. Conclusions Phacoemulsification with intraocular lens implantation and goniosynechialysis can control IOP well, improve vision rapidly.