表麻下小切口非超声乳化白内障摘除人工晶体植入术治疗闭角型青光眼的临床观察

Clinical study on the effect of small incision non-phacoemulsification cataract surgery and posterior chamber intraocular lens implantation under topical anaesthesia in the management of angle-closure glaucoma

目的观察小切口非超声乳化白内障联合人工晶体植入术治疗合并白内障的闭角型青光眼的疗效。方法回顾分析2005年5月～2009年1月,在我科收住的闭角型青光眼患者22例(25只眼)眼闭角型青光眼患者,其中14只眼为原发性闭角型青光眼,5只眼为原发性慢性闭角型青光眼,4只眼为继发性急性闭角型青光眼,2只眼为继发性慢性闭角型青光眼,患者均有不同程度的晶体混浊。患者入院后均行表麻下小切口非超声乳化白内障联合人工晶体植入术。结果术后最佳矫正视力较术前显著提高(P<0.05);患者术后眼压平均为(12.55±4.75)mmHg较术前用药后眼压相比有显著下降(P<0.05);术后前房深度较术前有显著增加,平均为(3.12±0.59)mm(P<0.05)。结论小切口非超声乳化白内障联合人工晶体植入术可有效降低眼压、提高视力,可有效治疗合并白内障的闭角型青光眼。

Objective To investigate the clinical results of small incision non-phacoemulsification cataract surgery and posterior chamber intraocular lens （PC-IOL）implantation under topical anaesthesia in the management of angle-closure glaucoma （ACG）.Methods Small incision non-phacoemulsification cataract surgery and PC-IOL implantation performed on 25 eyes （22 cases） with ACG,including 14 eyes with primary acute ACG,5 eyes with primary chronic ACG,4 eyes with secondary acute ACG and 2 eyes with secondery ACG.Results The best corrected visual acuity was significantly better after surgery （P0.05）.The mean intraocular pressure （IOP） decreased significantly after surgery.The anterior chamber depth and angle width increased significantly.Conclusion small incision non-phacoemulsification cataract surgery and PC-IOL implantation substantially reduced IOP and improved visual acuity and can be a good alternative in treatment of ACG with cataract.