青光眼合并白内障三联手术的疗效观察

Observation of efficacy of tri-combining surgery on glaucoma with cataract

目的:观察青光眼白内障小切口非乳化白内障囊外摘除+后房型人工晶状体植入+小梁切除术(简称三联手术)的疗效。方法:对56例62眼青光眼合并白内障患者施行三联手术并观察其术后疗效(包括矫正视力,眼压,滤过泡及并发症等)。术后随访2～36(平均22)mo。结果:术后矫正视力0.02～0.25者12眼(19%),视力在0.3～1.0者50眼(81%),术后眼压控制者60眼(97%),仅2眼眼压为21.87与22.15mmHg,但可通过局部药物控制。术后7d54眼(87%)呈扁平的功能性滤过泡,6眼呈泡状滤过泡,2眼滤过泡不明显。术后并发症主要为角膜水肿29眼(47%),前房渗出9眼(15%)与浅前房6眼(10%)。结论:青光眼合并白内障的三联手术是一种适宜在基层医院推广的安全有效且并发症较少的术式。

AIM： To observe the efficacy of small incision extracapsular cataract extraction and intraocular lens implantation combined with trabeculectomy （tri-combining surgery） on glaucoma with cataract. METHODS： Among 62 eyes of glaucoma with cataract underwent the tri-combining surgery and the efficacy including corrected vision, intraocular pressure, filter blebs and complications were observed. RESULTS： Corrected vision was 0.02-0.25 in 12 of 62 eyes （19%）,0.3-1.0 in 50 of 62 eyes （81%）. Intraocular pressure was controlled in 60 of 62 eyes （97%）, beside two eyes intraocular pressure were 21.87 and 22.15mmHg postoperatively, but the two could be controlled through topical drugs. There were 54 flat fuctional filter blebs in 62 eyes （87%）, 6 vesicular filter blebs and 2 inconspicuous filter blebs. The main postoperative complications were cornea edema （29 eyes, 47%）, anterior chamber exudation （9 eyes, 15%） and shallow anterior chamber （6 eyes, 10% ）.CONCLUSION. Tri-combining surgery of glaucoma and cataract is a safe, effective and lesser complications operation which is good for popularization at grass-roots hospitals.