单纯白内障摘除术治疗白内障膨胀期继发性青光眼

Study on the Treatment of Secondary Glaucoma due to Tumescent Senile Cataract Using Purely Cataract Extraction

[目的]探讨通过单纯白内障摘除术治疗白内障膨胀期继发性青光眼。[方法]46例患者的51只眼实施单纯白内障摘除术，观察手术前后术者的眼轴长度、眼压、房角和前房深度，并做统计学分析。[结果]伴发青光眼的白内障患者眼轴长度较无青光眼的白内障患者的眼轴显著短；青光眼患者术后3d时的眼压[（8～22）mmHg，平均（13．69±3．69）mmHg]较术前1d时的眼压[（16～35）mmHg，平均（26．89±4．32）mmHg]显著下降；手术后所有患者房角较术前都有不同程度的开放，并且前房深度均有显著增加。[结论]白内障膨胀期发生的青光眼主要原因是由于小眼球患者晶体膨胀后造成前房和房角结构发生改变，针对该类青光眼患者可以采用单纯白内障摘除手术治疗，解除病因后可达到降眼压从而治疗青光眼的目的。该方法只进行白内障手术，而避免了再行青光眼手术，减小了手术创伤，恢复快。

[Objective]To investigate surgical methods of treating secondary glaucoma due to tumescent senile cataract. [Methods]Forty six inpatient cases （51 eyes） who suffered from secondary glaucoma due to tumescent senile cataract underwent extracapsular cataract extraction （ECCE） or phacoemulsification combined with intraocular lens implant. The changes of the eye axis, intraocular pressure （IOP） , anterior chamber angle and the depth of anterior chamber were observed. [Results]The mean eye axis length of patients suffering from secondary glaucoma due to tumescent senile cataract was remarkable longer than controls. The mean intraocular pressure of inpatients had reduced from（26.89 ± 4.32mmHg） preoperatively to （13.69 ± 3.69mmHg） postoperatively. Anterior chamber angle was opening and depth of anterior chamber was increased after operation. [Conclusion] The main reason of secondary glaucoma due to tumescent senile cataract is that cataract inflation leads to structural change of anterior chamber angle. This kind of glaucoma patients can be treated by purely extracapsular cataract extraction （ECCE） or phacoemulsification combined with intraocular lens implant without glaucoma operation.