激光虹膜切除联合超声乳化吸除术治疗急性闭角型青光眼合并白内障临床观察，

Clinical investigation of lens phacoemulsification for the treatment of acute angle-closure glaucoma coexisting with cataract after laser peripheral iridectomy

目的探讨急性闭角型青光眼初次发作后，采用激光周边虹膜切除，再行晶状体超声乳化吸出联合人工晶体植入术治疗的疗效。方法分析2005年9月至2007年3月收治急性闭角型青光眼合并白内障患者16例，16只眼，应用激光周边虹膜切除术后，行晶状体超声乳化吸出联合人工晶体植入，观察术前及术后视力、周边前房深度、前房角、眼压情况。术后随诊4～12个月，平均9．4个月。结果16只眼术后视力、周边前房深度较术前明显改善，前房角完全开放，眼压非药物控制于正常范围，平均眼压14．24mmHg。术后早期并发角膜水肿3只眼，前房纤维样渗出2只眼，无浅前房和后发障发生。结论应用激光周边虹膜切除后，行晶状体超声乳化吸出人工晶体植入可有效治疗急性闭角型青光眼合并白内障，且术后视力恢复快、眼压控制好、并发症少。

Objective To investigate the clinical effect of phacoemulsification combined with intraoeular lens （IOL） implantation operation after laser peripheral iridectomy for the treatment of the initial attack of acute angle-closure glaucoma. Methods This retrospective study was？conducted？in 16 patients （ 16 eyes） of acute angle-closure glaucoma coexisting with cataract, who underwent the combined surgery of laser peripheral iridectomy and phacoemulsification with posterior chamber IOL implantation from September 2005 to March 2007. Visual acuity, peripheral anterior chamber depth and intraocular pressure （lOP） of anterior chamber angle in pre- and post-operation were observed. Cases were followed up for 4 -12months （9.4 months on average）. Results Best-corrected visual acuity （BCVA） and peripheral anterior chamber depth of all cases were much better than that of preoperation. The anterior chambers completely opened and lOP were controlled without any drug in the normal range （14.24 mmHg on average）. But there were some corneal edema in 3 eyes ,fiber-exudation of anterior chamber in 2 eyes and no shallow anterior chamber and after-cataract in the early postoperation. Conclusion Application of phacoemulsification combined with intraoeular lens implantation operation after laser peripheral iridectomy can be effective in the treatment of acute angle-closure glaucoma coexisting with cataract, and it has advantages of quick recovery of visual acuity, good control oflOP and low complications in postoperation. The method can be used as the initial treatment of acute angle-closure glaucoma.