超声乳化联合房角分离治疗原发性闭角型青光眼并白内障

Phacoemulsification combined with goniosynechialysis for primary angle-closure glaucoma with cataract

目的探讨白内障超声乳化联合房角分离治疗原发性闭角型青光眼合并白内障的有效性和安全性。方法对已确诊为原发性闭角型青光眼合并白内障42例54眼施行白内障超声乳化摘除,对房角粘连区域用粘弹剂钝性分离。房角镜观察手术前后房角变化,前房变化,眼压监测,视野电生理检测,房水流畅系数与压畅比变化,随访3～29个月,平均16.5个月。结果眼压术前(52.87±9.86)mmHg,随访时平均(12.19±3.96)mmHg。房角术后全部开放46眼,部分开放8眼;术前前房深度平均(1.62±0.26)mm,术后平均(1.21±0.14)mm。随诊54眼视野均无缩小;房水流畅系数(C)术前平均0.098±0.005,术后平均0.201±0.03。压畅比(PO/C):术前平均127.32±6.01,术后平均89.3±4.87。结论超声乳化联合房角分离治疗原发性闭角型青光眼合并白内障是一种有效、安全的方法。

Objective To study the efficacy and safety of phacoemulsification combined with goniosynechialysis for primary angle-closure glaucoma with cataract.Methods The 54 eyes of primary angle -closure glaucoma with cataract were treated with phacoemulsification combined with goniosynechialysis . The main outcome measures were pre-operation and post-operation change of anterior chamber angle, depth of anterior chamber ,visual field and intraocular pressure, coefficient of outflow （C）, PO/C. The mean follow-up duration was 16.5 months. Results The mean intraocular pressure was reduced from 52.87±9.86mmHg of preoperation to 12.19±3.96 mmHg of postoperation （P〈 0.05）.The anterior chamber angles of 46 eyes were open. The mean anterior chamber depth was 1.62±0.26mm preoperatively and deepened average 1.21±0.14mm. The visual fields of 54 eyes had no depression.The mean C was 0.098±0.005 of preoperation to 0.201±0.03 of postoperation. The mean PO/C was 127.32±6.01 of preoperation to 89.3±4.87 of postoperation.Conclusion Phacoemulsification combined with goniosynechialysis is an effective and safe surgical procedure for treating primary angle-closure glaucoma with cataract.