表麻下青光眼白内障联合手术治疗闭角型青光眼效果观察

Clinical evaluation of topical anesthesia in cataract surgery and trabeculectomy for angle closure glaucoma

目的探讨在爱尔凯因表面麻醉下行超声乳化白内障吸出折叠式人工晶状体植入联合小梁切除术治疗闭角型青光眼合并白内障的临床疗效。方法回顾性分析37例(45眼)闭角型青光眼合并白内障在0.5%爱尔凯因表面麻醉下行超声乳化白内障吸出折叠式人工晶状体植入联合小梁切除术治疗的临床资料。结果所有患者术中均能很好配合,无一例更换麻醉方法。术后随访3～24月,患眼术后视力均较术前显著提高,眼压全部降至正常范围,由术前平均(31.8±4.3)mmHg降至术后(13.1±5.2)mmHg,功能性滤过泡者42眼,占(93.3%),术中术后均未发生严重并发症。结论在爱尔凯因表麻下行超声乳化白内障吸出折叠式人工晶状体植入联合小梁切除术是治疗闭角型青光眼合并白内障的一种安全、有效、经济的方法。

Objective To evaluate the topical anesthesia in combined surgery of phacoemulsifieation and foldable intraocular lens implantation and trabeculectomy. Methods 37 eases （45 eyes） received 0.5% Alcaine topical anesthesia in phaeoemulsification and intraocular lens implantation and trabeculectomy were retrospectively analysed. Results All operations were well done under topical anesthesia with Aleaine, without any additional anesthesia. They were followed up for 3 to 24 months. Postoperative visual acuity was significantly improved,The mean postoperative IOP of 37 eases （45 eyes） was （13.1 ±5.2） mmHg,whieh was distinctly lower than that of preoperative IOP, which was （ 31.8± 4.3 ） mmHg. The functional filtering blebs presented in 42 eyes （93.3%）. There were no serious operative complications or postoperative complications. Conclusion The combined surgery of phacoemulsification and foldable IOL implantation with trabeculectomy was safe, effective and economic for patients suffered by angle closure glaucoma and cataract.