超声乳化术治疗膨胀期白内障继发青光眼34例

Phacoemulsification in treatment of secondary glaucoma due to intumescent cataract in 34 cases

目的评价透明角膜切口超声乳化白内障吸除联合人工晶体植入术，治疗膨胀期白内障继发青光眼的临床疗效。方法回顾分析34例（41眼）膨胀期白内障继发青光眼患者临床资料，其中用药后眼压控制良好择期手术34眼、高眼压条件下急诊手术7眼，均采用透明角膜切口白内障超声乳化联合后房折叠型人工晶体植入术。术后随访2个月-3年，对比术前术后视力、眼压、前房深度和房角开放范围。结果术中、术后所有患者均未发生严重手术并发症。术后最佳矫正视力明显好于术前（P〈0．01）；眼压比入院接诊时明显下降（P〈0．001）；前房深度加深，术前术后差异有统计学意义（P〈0．001）。41眼中有2眼术后半年加用抗青光眼药物。所有患者原狭窄房角增宽，关闭的房角部分开放。结论白内障超声乳化摘除联合人工晶体植入术是治疗膨胀期白内障继发青光眼的一种有效手段。

Objective To explore the clinical effect of phacoemulsification with foldable lens implantation through a clear corneal incision in treatment of secondary glaucoma due to intumescent cataract. Methods The clinical data of 34 cases （41 eyes） of secondary glaucoma due to intumescent cataract admitted to our hospital from June 2003 to March 2007 were retrospectively analyzed. Of them, 34 eyes whose intraocular pressure （IOP） was controlled by drugs underwent delayed phaeoemulsifieatians with foldable IOL implantations through clear corneal incisions, and 7 eyes whose high lOP was not controlled underwent emergent operations. The lOP, best corrected eye vision （BCVA）, depth of the anterior chamber （AC） and width of the AC were determined before and after the operations. Patients were followed up from 2 months to 3 years. Results All patients were sueeessfally operated on without severe complications, the mean BCVA was significantly increased after the operations, [0.40 ± 0.21 vs 0.15 ± 0.09（ P 〈 0 01 ） ], the mean IOP was significantly decreased after the operations [ （ 14.2 ± 4.03） mmHg vs （32.36 ± 6.83 ） mmHg （P〈 0.01）], the depth of AC significantly increased after the operations [（2.48±0.37）ram vs （1.14±0.38）ram （P〈 0.01） ], and the angles of AC became wider after the operations. 2 eyes were given anti-glaucoma drugs to decrease the lOP six months after the operation. Conclusion Phacoemulsificafion with foldable lens implantation through a clear corneal incision is an effective means for secondary glaucoma due to intumescent cataract.