白内障超声乳化联合房角粘连分离术治疗闭角型青光眼合并白内障

Combined phacoemulsification and goniosynechialysis for angle-closure glaucoma complicated with cataract

目的:观察白内障超声乳化人工晶状体植入联合房角粘连分离术治疗闭角型青光眼的疗效以及术后房角形态的改变。方法:白内障超声乳化联合房角分离术治疗闭角型青光眼48例(54眼),对手术前后的视力、眼压、视野、中央前房深度、房角形态进行对照观察。结果:术后随访3～6mo,54眼中48眼视力较前有明显提高。54眼前房深度均加深,术前前房深度(1.612±0.354)mm,术后前房深度(3.296±0.243)mm。54眼术后眼压明显降低,术前眼压(22.42±3.53)mmHg,术后眼压(13.52±3.24)mmHg。房角镜检查术后1mo和3mo随访房角均开放,未发现房角再粘连。48例术后6mo复查视野无缩小。结论:白内障超声乳化房角分离术可有效治疗闭角型青光眼合并白内障的患者。

AIM： To investigate the clinical effect of phacoemulsification combined with goniosynechialysis in the management of chronic angle-closure glaucoma with cataract, and to observe morphologic changes of chamber angle after the surgery. METHODS： A total of 48 patients （54 eyes） with angle-closure glaucoma and cataract were treated with phacoemulsification combined with goniosynechialysis. The visual acuity, ocular pressure, visual field, central anterior chamber depth and morphology of chamber angle were observed and compared before and after the surgery. RESULTS： Patients were followed up for 3 to 6 months after the surgery. The best corrected visual acuity was fmproved in 48 of 54 eyes. Anterior chamber depth was deepened in all 54 eyes from （1.612 ± 0. 354） mm preoperatively to （3. 296±0. 243） mm postoperatively. The intraocular pressure of 54 eyes were obviously reduced from preoperative mean of （22.42±3.526） mmHg to postoperative mean of （13. 52±3. 236） mmHg. The postoperative gonioscopy showed that chamber angle was open at 1 month and 3 months and no synechia was found any more. The visual field of 48 cases was not narrowed at 6 months after the surgery. CONCLUSION： The management of chronic angle-closure glaucoma and cataract by phacoemulsification combined with goniosynechialysis is safe and effective.