青光眼术后颞侧巩膜小切口手法白内障摘出术

Temperal scleral manual extracapsular cataract extraction by small incision in patients after glaucoma surgery.

目的评价青光眼小梁切除术后经颞侧巩膜隧道小切口非超声乳化手法娩核囊外摘出术治疗白内障的手术方法和临床效果。方法对38例42眼施行手术。常规球后麻醉。于颞侧角膜缘后2.0 mm行直线形或反眉形巩膜板层切开,长为5.5 mm,作隧道切口至透明角膜内1 mm。注入黏弹剂,行连续环行撕囊或开罐式截囊,直径6 mm,水分离后以旋转法将晶状体核旋入前房,以晶状体圈匙将核托出。以注吸针头吸净晶状体皮质。囊袋内植入人工晶状体。术中缩瞳。术后随访至少3月,观察视力、眼压、滤过泡等。结果本组38例42眼术后第3天视力≥0.5者29眼(69.04%),术后眼压均在正常范围内,对原滤过泡无影响,未见严重并发症。结论青光眼术后特别是上方小梁切除术后的白内障患者,经颞侧巩膜隧道式小切口进行手法娩核白内障手术切实可行,效果良好,值得向基层医院推荐。

Objective To evaluate the clinical effect and the operation method for the patients accepted small incision non-phacoemulsification cataract extraction by temperal scleral tunnel incision,after trabeculectomy for glaucoma.Methods Non-phacoemulfisicafion small temperal scleral tunnel incision extracapsular cataract extraction and IOL implantation were performed in 38 cases（42 eyes）.They had been followed-up more than 3 months after the operation.We observed the postoperative introocular pressure（IOP）,visual and filtering blebs.Results The postoperative visual of all the eyes were raised.The visual was better than 0.5 in 29 eyes（69.04%） after the third day of operation.IOP of all the eyes was normal.Itself filtering blebs were no influence.There was no severe intra and postoperative complications.Conclusions Temperal scleral manual extracapsular cataract extraction by small incision in patients after glaucoma surgery,specially had trabeculectomy by upward incision,is effective.The surgery is worth to introduce to the basic hospital.