晶状体超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术治疗青光眼合并白内障

Phacoemulsification and intraocular lens implantation combined with trabeculectomy under tunnel sclera flap for glaucoma combined with cataract

目的探讨晶状体超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术治疗青光眼合并白内障的效果及安全性。方法对青光眼合并白内障52例(52眼)患者行超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术,术后随访3个月,观察眼压、视力、滤过泡及并发症情况。结果术后3个月,平均眼压为(14.38±4.37)mmHg(1kPa=7.5mmHg),较术前平均下降10.75mmHg;矫正视力≥0.5者28眼;功能性滤过泡41眼,非功能性滤过泡11眼。术中2眼后囊膜破裂,术后早期11眼角膜水肿、5眼浅前房,术后晚期4眼发生后发性白内障。结论超声乳化白内障吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术安全有效,视力恢复快,降压效果好,适用于青光眼合并白内障。

Objective To investigate the safety and effeicacy of phacoemulsification and intraocular lens （IOL） implantation combined with trabeculectomy under tunnel sclera flap for glaucoma combined with cataract. Methods Phacoemulsifieation and IOL implantation combined with trabecuiectomy under tunnel sclera flap was performed in 52 patients （ 52 eyes） suffering from glaucoma combined with cataract. All patients were followed up for 3 months postoperatively. Intraocular pressure, visual acuity,filtration bubbles and complications were observed. Results At postoperative 3 months,the average intraocular pressure was （ 14.38 ± 4.37 ） mmHg（ 1 kPa = 7.5 mmHg） and lower 10.75 mmHg than preoperative intraocular pressure. There were 28 eyes with corrected visual acuity be and higher than 0.5,41 eyes with functional infiltration bubbles, 11 eyes with nonfunctional infiltration bubbles. There were 2 eyes with posterior capsular rupture intra-operatively, 11 eyes with corneal edema and 5 eyes with shallow of anterior chamber at postoperative early stage and 4 eyes with after-cataract at postoperative late stage. Conclusions Phacoemulsification and IOL implantation combined with trabeculectomy under ttmnel scleral flap is safe and effective, with fast recovery of visual acuity and good efficacy of reducing intraocular pressure,and good for glaucoma combined with cataract.