超声乳化联合房角分离术治疗原发性闭角型青光眼

Phacoemulsification combined with goniosynechialysis for therapy of primary angle-closure glaucoma

目的观察超声乳化白内障吸除人工晶状体植入联合房角分离术治疗合并有白内障的原发性闭角型青光眼的疗效。方法回顾性分析合并有白内障的闭角型青光眼患者35例（37眼），其中前房角关闭范围≤180°者16眼，〉180°者21眼，均行角巩膜隧道切15超声乳化白内障吸除折叠式人工晶状体植入联合房角分离术，对其手术前后的视力、眼压、视野、中央前房深度、房角状态进行对照观察。结果随访3～24个月，术后视力除2眼有视神经萎缩外，余均有不同程度提高，末次随访平均眼压（14．31±4．13）mmHg（1mmHg=0．133kPa），较术前用药后平均眼压（26．42±3．22）mmHg明显降低，差异有统计学意义（t：5．86，P〈0．01），中央前房深度由术前的（2．0±0．3）mm，增加到术后的（3．2±0．4）mm，房角状态与术前相比有3眼大部分开放，余房角均开放。结论对于合并有白内障的闭角型青光眼的治疗，行超声乳化白内障吸除折叠式人工晶状体植入联合房角分离术能有效降低眼压，开放房角，加深前房，提高视力，手术并发症少。（中国眼耳鼻喉科杂志，2008，8：307—308）

Objective To observe the effect of phacoemulsification eombined with intraocular lens implantation and goniosynechialysis for the therapy of primary angle-closure glaucoma and cataract. Methods Data of 30 patients （37 eyes） with primary angle-closure glaucoma combined with cataract were analyzed retrospectively, including 16 eyes with range of elosed-angle≤180~ and 21 eyes 〉 180~. All patients were treated with phacoenmulsification and intraocular lens implantation combined with goniosynechialysis. The preoperative and postoperative intraocular pressure, anterior chamber angle and visual acuity was monitored. Results After 3 to 24 months＇ follow-up period, the corrected visual acuity of post-operation was improved except 2 eyes with optic atrophy. The mean postoperative intraoeular pressure （IOP） was （ 14.31±4.13 ） mm Hg （ 1 mm Hg =0.133 kPa）, significantly decreased compared with the preoperative tOP [ （ 26.42±3.22） mm Hg ; t = 5.86, P 〈 0.01 ]. The preoperative and postoperative mean central anterior chamber depth was （ 2.0 ±0.3 ）nun and （3.2±0.4）mm. All postoperative chamber angles were wider than the preoperative ones. Conclusions The combined procedure of phacoemulsification and goniosynechiaysis was a safe treatment with few complications and has a good visual outcome in patients with primary angle-closure glaucoma and cataract. （ Chin J Ophthahnol and Otorhinolaryngol, 2008,8 ： 307 -308 ）