白内障囊外摘除联合房角分离术治疗急性闭角型青光眼

Extracapsular cataract extraction combined with goniosynechialysis for acute angle closure glaucoma

目的:观察白内障囊外摘除人工晶体植入联合房角分离术治疗合并有白内障的急性闭角型青光眼的疗效,以及术后房角形态的改变。方法:白内障囊外摘除联合房角分离术治疗急性闭角型青光眼34例(37眼),对其手术前后的视力、眼压、视野、中央前房深度、房角形态进行对照观察。结果:手术180 d后随访,34例(37眼)中有28例(30眼)视力较术前显著提高。术前前房深度(1.674±0.478)mm,眼压(28.436±3.325)mmHg,术后30 d前房深度(3.412±0.169)mm,术后7 d眼压(13.983±5.196)mmHg。术后30 d房角镜检查34例(37眼)房角均开放。27例(28眼)术后6个月复查视野无缩小。结论:白内障囊外摘除联合房角分离术能使此类患者降低眼压、加深前房、开放房角和提高视力。

Objective： To investigate the clinical effect of extracapsular cataract extraction combined with goniosynechialysis in treatment of acute angle closure glaucoma with cataract. Methods： Thirty-four patients （37 eyes） were subjected to this management. The anterior chamber depth, visual acuity, configuration of chamber anger, and intraocular pressure were determined. Results： After a mean postoperative follow-up of 180 days, the best corrected visual acuity was improved in 28 cases （30 eyes）. The mean anterior chamber depth was 1. 674 ± 0. 478 mm pre-operatively and 3.412 ± 0. 169 mm at post-operative 30 days （ t = 6.743, P 〈 0.001 ）. The intraocular pressure was decreased from a pre-operative of 28.436 ± 3. 325 mmHg to a postoperative 7-day of 13. 983 ± 5. 196 mmHg （ t = 5. 263, P 〈 0.001 ）. Angles of the anterior chamber were opened at post-operative 30 days in all 34 patients. The visual field was not significantly changed in 15 patients at six months after operation. Conclusion： Extracapsular cataract extraction combined with lysis of the synechiae is safe and effective for acute angle closure glaucoma.