超声乳化术联合小梁切除术治疗急性闭角性青光眼合并白内障

Combined phacoemulsification,foldable intraocular lens implantation and trabeculectomy for acute angle-closure glaucoma with cataract

目的探讨晶状体超声乳化及人工晶状体植入术联合小梁切除术及术中应用丝裂霉素C(MMC)治疗急性闭角性青光眼合并白内障的临床效果。方法回顾分析13例(13只眼)急性闭角性青光眼(前房角粘连关闭均>180°)合并白内障行透明角膜切口超声乳化及人工晶状体植入,联合小梁切除术及术中应用丝裂霉素,注意观察手术前、后的视力和眼压,手术并发症及滤过泡情况。结果术后随访时间3～6个月。13只眼眼压均降致正常范围,视力有不同程度提高;术后根据Kronfeld分类,Ⅰ、Ⅱ型功能滤过泡4只眼(30.8%),非功能Ⅲ型滤过泡9只眼(69.2%)。结论透明角膜切口晶状体超声乳化及人工晶状体植入术联合小梁切除术及术中应用丝裂霉素(MMC)治疗急性闭角性青光眼合并白内障是一种安全、有效的治疗方法 ,可以明显降低眼压,提高视力。

Objective To observe the clinical effects of phacoemulsification, IOL implantation combined with trabeculectomy and mitomycinC （MMC） in acute angle-closure glaucoma with cataract. Methods In 13 cases （ 13 eyes） with acute angle-closure glaucoma and cataract who underwent clear corneal incision phacoemulsification and IOL implantation combined with trabeculectomy and MMC in our hospital were retrospectively analyzed. All cases chamber adhesion were more than 180°. Patients＇ visual acuity , intrancular pressure（lOP） before and after the operation were recorded as well as their surgical complication and frltering bleb condition. Results After follow-up for 3 - 6 months, all patients ＇, visual acuity were improved and IOP were normal after operation. The filtering blebs of tape Ⅰ , Ⅱ（ functional ） by Kronfeld＇ s clas- sification presented in 4 eyes （30.8% ） and tape Ⅲ （ non-functional） in 9 other eyes（69.2% ）. Conclusion The combined surgery of clear corneal incision phacoemulsification, IOL implantation and trabeculectomy and MMC is a safe and effective surgery for patients with acute angle-closure glaucoma and cataract. This combined surgery can improve visual acuity and control IOP.