滤过术后选择性隧道切口晶状体超声乳化人工晶状体植入

Phacoemulsification combining with intraocular lens implantation for glaucoma patients with preexisting filtering bleb

目的评价青光眼滤过术后晶状体超声乳化白内障摘出人工晶状体植入术的效果。方法对33例(51眼)青光眼滤过术后的白内障,采用选择性切口行晶状体超声乳化白内障摘出入工晶状体植入。随诊3～18月,观察术后滤过泡、眼压、视力及并发症等情况。结果51眼术前视力手动～0.6,术后视力均较术前明显提高。其中,0.05～0.2者2眼(3.92%),0.3～0.4者7眼(13.73%),0.5～0.8者12眼(23.53%),1.0～1.2者30眼(58.82%)。13眼滤过泡无影响,眼压均在正常范围。24眼有不同程度的角膜水肿、炎症反应,用药后恢复,无角膜失代偿。结论青光眼滤过术后白内障,采用选择性隧道切口行晶状体超声乳化白内障摘出人工晶状体植入术,可以避开滤过泡,保护原有滤过功能,术后反应轻,视功能恢复好,手术安全可靠。

Objective To evaluate the effect of phacoemulsi- fication and lens implantation for glaucoma patients with preexisting filtering bleb. Methods Phacoemulsification and lens implanta- tion through selective small tunnel incision was performed on （51 eyes） of 33 cataract patients with preexisting filtering bleb. Postop- erative filtering bleb, intraocular pressure, visual acuity and com- plication were observed. The follow - up period was 3 - 18months. Results The mean preoperative visual acuity were from hand mov- ing to O. 6. Postoperative visual acuity were more better. The visual acuity of 0.05 -0.2 in 2 eyes （3.9%）, 0.3 -0.4 in 7 eyes （13.7%）, 0.5-0.8 in 12 eyes （23.5%）,1.0-1.2 in 30 eyes （58.9%）. Filtering bleb in 48 eyes were not affected. Intraocular pressure were all in normal. Cornea edema in 24 eyes recovered af- ter treatment. Conclusions Phacoemulsification and lens implan- tation through selective tunnel incision is a safe and effective meth- od to treat cataract after glaucomatous filtering surgery.