合并白内障的闭角型青光眼持续高眼压下手术治疗的临床分析

Clinical Analysis of Phacoemulsification Combined with Trabeculectomy in Patients with Angle-closure Glaucoma and Cataract with High Intraocular Pressure

目的探讨超声乳化联合小梁切除与先行小梁切除再行超声乳化分期手术治疗持续高眼压状态下合并白内障的原发性闭角型青光眼手术的安全性、有效性及并发症。方法回顾分析32例应用药物治疗不能降低眼压(≥35mmHg)的合并白内障的原发性闭角型青光眼患者32眼,其中16眼采用白内障超声乳化人工晶体植入联合小梁切除术,16眼采用小梁切除术后择期行白内障超声乳化人工晶体植入术治疗,观察术后视力、眼压及并发症情况。结果两组患者术中术后均未出现严重并发症,术后1周视力提高及眼压降低效果无显著性差异。择期手术组面临小梁切除术后人工晶体度数计算不确定,术后散光以及晶体膨胀加重浅前房问题。结论对于药物治疗不能有效控制眼压的合并白内障的原发性闭角型青光眼患者应及时手术治疗。超声乳化联合小梁切除术安全、有效,但需结合患者情况、眼压情况、手术熟练程度综合考虑。

Objective To evaluate the efficacy and safety of phacoemulsification combined with trabeculectomy and phacoemulsification after trabeculectomy in patients with angle-closure glaucoma and cataract with high intraocular pressure. Methods We divided 32 eyes of 32 patients with angle-closure glaucoma and cataract with high intraocular pressure into 2 groups. Phacoemulsification combined with trabeculectomy were performed in group 1,and phacoemulsification after trabeculectomy were performed in group 2. The intraocular pressure,visual acuity,and complications were determined. Results In these 2 groups,the intraocular pressure decreased and the visual acuity increased 1 week after the surgery,without statistical significance. No serious complication was found in these 2 groups. Conclusion It is effective and safe to perform phacoemulsification combined with trabeculectomy in patients with angle-closure glaucoma and cataract with high intraocular pressure.