复合式小梁切除术治疗人工晶状体植入术后继发青光眼的临床观察

Investigation and clinical observation of composite glaucoma filtration surgery after intraocular lens implantation through a clear corneal incision

目的 探讨复合式小梁切除术治疗经透明角膜切口人工晶状体植入术后继发青光眼的疗效及意义.方法 31例（32只眼）经透明角膜切口人工晶状体植入术后继发青光眼行常规复合式小梁切除术.术后观察视力、眼压、滤过泡、浅前房及其它并发症.结果 手术12月后：视力增进2/32只眼（6.2%）,不变28/32只眼（87.6%）,下降2/32只眼（6.2%）.功能性滤过泡24/32只眼（75.0%）.眼压≤21mmHg（1kPa=7.5mmHg）者26/32只眼（81.2%）,术后早期并发症有浅前房5只眼（15.5%）,前房出血3只眼（9.3%）低眼压性黄斑病变2只眼（6.2%）,脉络膜脱离1只眼（3.1%）.结论 复合式小梁切除术是治疗经透明角膜切口人工晶状体植人术后继发青光眼的有效方法,此类青光眼不应归属于难治性青光眼.

Objective To estimate efficacy of composite glaucoma filtration surgery after intraocular lens implantation through a clear corneal incision.Methods Thirty-one cases （32 eyes） of secondary glaucoma following posterior chamber intraocular lens implantation were treated by composite glaucoma filtration surgery. The visual acuity, intraocular pressure, functional filter blebs, anterior chamber depth and postoperative complications were observed.Results Followed-up for 12 months after surgery, visual acuity of 2 eyes （6.2%） increased, 28 eyes （87.6%） maintained and 2 eyes （6.2%） dropped.The success rate of functional filter blebs was 24 seen in eyes （75.0%）.The ocular pressure of 26 eyes dropped to 21 mmHg （lkPa=7.5 mmHg） below （81.2%）.The complications included shallow anterior chamber （5 eyes, 15.5%）, hyphema （3 eyes, 9.8%）, hypotous maculopathy （2 eyes, 6.2%）, choroidal detachment （1 eye, 3.1% ）.Conclusions Composite glaucoma filtration surgery is an effective method to treat secondary glaucoma after intraocular lens implantation through a clear corneal incision.This kind of secondary glaucoma is not ascribed to refractory glaucoma.