超声乳化白内障吸除人工晶体植入术治疗合并白内障原发性闭角型青光眼的疗效观察

Clinical Study on the Effect of Phacoemulsification with Foldable Posterior Chamber Intraocular Lens Implantation in the Management of Primary Angle-closure Glaucoma

【目的】探讨超声乳化白内障吸除联合折叠式人工晶体植入术治疗合并白内障的原发性闭角型青光眼的临床疗效。【方法】分析2002年3月至2007年5月本院收治的合并白内障的原发性闭角型青光眼患者36例（38眼），所有患者均接受超声乳化白内障吸除联合折叠式人工晶体植入术，术后随访3个月。测量并记录术前、术后1d、1周、1个月、3个月的最佳矫正视力、眼压、眼前房深度、前房角宽度。【结果】术后最佳矫正视力较术前显著提高（P〈0．05）；患者术后3个月眼压平均为（15．5±2．7）mmHg（1mmHg=0．133kPa），较术前用药前后眼压相比均显著下降（P〈O．05）；超声生物显微镜检查发现术后眼前房深度较术前均显著增加，平均为（2．98±0．38）mm（P〈0．05）；术后患者房角均较术前增宽，房角粘连关闭象限不同程度开放。【结论】超声乳化白内障吸除联合折叠式人工晶体植入术可有效降低眼压、提高视力，为合并白内障的原发性闭角型青光眼患者安全有效的治疗方法。

[Objective]To evaluate the clinical effect of phacoemulsification with foldable posterior chamber intraocular lens implantation （PC-IOL） in the management of primary angle-closure glaucoma complicated with cataract. [Methods]Phacoemulsification with foldable PC-IOL implantation was performed on 36：cases （38 eyes） with primary angle-closure glaucoma complicated with cataract between March 2002 and May 2007. The postoperative follow-up was 3 months. The best corrected visual acuity （BCVA）, intraocular pressure （lOP）, anterior chamber depth （ACD） and anterior chamber angle width were measured and recorded preoperatively and postoperatively at 1 day, 1 week, 1 month and 3 months. [Results]The BCVA was significantly better af ter surgery （ P 〈0.05）. The mean IOP decreased significantly after surgery （ P 〈0.05）. Using ultrasound biomicroscopy, it was found that ACD and angle width increased significantly. [Conclusion]Phacoemulsifica- tion with foldable PC-IOL implantation can substantially reduce IOP and improve visual acuity, and can be a good alternative in the treatment of primary angle-closure glaucoma complicated with cataract.