超声乳化植入治疗原发性闭角型青光眼的临床观察

目的前瞻性研究超声乳化白内障摘除折叠人工晶体植入治疗原发性闭角型青光眼(PACG)的安全性、有效性。方法选择早期原发性闭角型青光眼合并不同程度的白内障患者32例(36只眼),其中男性12例,女性20例(24眼),年龄(59.70±7.26)岁,临床前期21例(25眼),急性发作期3例(3眼),缓解期8例(8眼)。术前眼压(22.36±8.55)mmHg(范围14～30.11mmHg),经保守治疗眼压控制在正常范围(22mmHg以下),房角粘连闭合在1/2圆周以内,视力在0.3以下。对以上患者行单纯性超声乳化白内障摘除,联合折叠人工晶体植入,术后随访6个月至18个月,观察视力、眼压、前房深度的改变和并发症。结果术后36只眼视力均有不同程度提高,眼压控制在10～18mmHg(15.68±3.90mmHg),房角均有增宽,部分患者前房开放,前房深度正常,未发现术后并发症。结论超声乳化白内障摘除折叠人工晶体植入对房角粘连在1/2圆周以内的原发性闭角型青光眼可提高视力,控制眼压及开放房角,是一种安全、有效的方法。

Objective Prospective study on the clinical effect of phacoemulsification with foldable posterior chamberintraocular lens （PC-IOL） implantation in the management of angle-closure glaucoma with cataract. Methods Thirty-two cases（36 eyes）with primary angle-closure glaucoma and cataract undergoing pha-coemulsification with PC-IOL implantation were studied, including 12 men and 20 women（24 eyes）,25 eyes with preclinical stage,3 eyes with acute attack stage and 8 eyes with remission stage. The mean age was （59.70±7.26） years.The intraocular pressure was reduced from a preoperative mean of（22.36±8.55）mmHg to nomal by medication.these patients with less than 180 degrees synechial angle closure and less than 0.3 visual acuity ,were treated with phacoemulsification with foldable posterior chamberintraocular lens （PC-IOL） implantation. Visual acuity , intraocular pressure, anterior chamber angle and complications were monitored during follow-up for 6-18 months in these eyes. Results The Visual acuity were improved, intraocular pressure were reduced to（15.68±3.90）mmHg, anterior chamber angle became wider in all eyes. Most of anterior chamber angle were reopened and no complications were found after surgery. Conclusion Phacoemulsification foldable posterior chamberintraocular lens （PC-IOL） implantation is able to effectively control IOP, open chamber angle and also improve the visual acuity of primary angle-closure glaucoma with equal to or less than 180 degrees synechial angle closure.