晶状体超声乳化术治疗合并白内障的闭角型青光眼

Treatment of angle-closure glaucoma by with cataract phacoemulsification with posterior chamber intraocular lens implantation

目的观察晶状体超声乳化联合后房型人工晶状体植入治疗合并白内障的原发性闭角型青光眼的疗效和价值。方法对35例（39眼）合并有白内障的青光眼行超声乳化后房型人工晶状体植入术,其中急性闭角型青光眼临床前期8眼,发作期15眼;慢性闭角型青光眼16眼。术后随访3-24个月。结果急性闭角青光眼临床前期组平均眼压较术前明显下降（t=3.3420,P〈0.01）。急闭发作期组术后眼压较明显下降（t=4.3741,P〈0.01）。慢闭组术后眼压平均亦明显下降（t=4.1362,P〈0.01）;急、慢闭组前房角均较术前增宽;急、慢闭组前房轴深较术前加深;周边前房深度两组均较术前增加。所有病例术后最佳矫正视力均提高,21眼（53.9%）最佳矫正视力〉0.4。结论晶状体超声乳化术对合并白内障的急闭临床前期、急慢闭青光眼均可产生良好的降眼压效果,且视力恢复较好。

Objective To evaluate the effect and value of the phacoemulsification with posterior chamber intraocular lens（PC-IOL） implantation for acute and chronic angle-closure glaucoma（AACG or CACG） with cataract. Methods Phacoemulsifacation and pc-iol implantation was performed on 35 cases （39 eyes） with angle-closure glaucoma combined cataract.Including 8 eyes of preclinical AACG,15 eyes of paroxysmal AACG,16 eyes of CACG.The patients were followed up from 3 to 12 months. Results In preclinical AACG group,postoperative IOP decreased（t=3.3420,P〈0.01）;in paroxysmal AACG group,postoperative IOP decreased markedly（t=4.3741,P〈0.01）,in CACG group,postoperative lOP decreased（t=4.1362,P〈0.01）.Anterior chamber angle were wider than that of preoperation in AACG and CACG groups.Postoperative central and peripheral anterior chanber depth（ACD） were increased than those of preoperation in all cases.The best corrected visual acuity improved in all patients and more than 53.9%0.4. Conclusion Phacoemulsification and PC-IOL implantation can be a idle alternative for angle-closure glaucoma combined cataract,it not only decrease IOP but also improve visual acuity.