隧道式小切口在青光眼白内障联合手术中的应用

The application of combined triple surgery of small scleral tunnel incision for cataract accompanied glaucoma

目的探讨隧道式小切口白内障囊外摘除后房型人工晶体植入联合小梁切除术(即小切口三联术)的临床效果。方法不同类型的青光眼伴白内障患者38例42眼,行隧道式小切口白内障囊外摘除后房型人工晶体植入联合小梁切除术,术后随访6-24月,平均12.5月,对视力,眼压,滤过泡及并发症进行临床观察。结果术后随访视力≥0.5者26眼,占61.9%;0.2-0.4者9眼,占21.4%,视力<0.2者7眼,占16.7%。眼压控制在正常范围(<21mmHg)38眼,占90.5%,4眼术后眼压在21-24.38mmHg,用噻吗洛尔眼水滴眼,眼压可控制正常。功能性滤过泡占80.9%,无严重并发症。结论隧道式小切口白内障摘除及后房型人工晶体植入联合小梁切除是既有效,又经济的治疗方法,值得推广。

Objective To explore the therapeutic effect of combined triple surgery of trabeculectomy and small incision extracapsular cataract extraction（ECCE）,intraocular lens（IOL）implantation . Methods Glancoma trabeculectomy combined with ECCE and IOL implantation was performed through small scleral tunnel incision on 42 eyes of 38 patients with cataract and glaucoma. All cases were followed up for 6-24 months（mean 12.5 months）.Vision,intraocular pressure,filter blebs and complications were observed. Results Vision was 0.5 in 26 of 42 eyes（61.9%）,0.2-0.4 in 9 of 42 eyes（21.4%）,〈0.2 in 7 of 42 eyes（16.7%）,intraocular pressure was contralled in normal range（21 mmHg） in 38 of 42 eyes（90.5%）.4 eyes intraocular pressure was about 21-24.38 mmHg and could be controlled in normal range by timolol.34 of 42 eyes（80.9%） had the functional blebs. No serious complications occurred. Conclusions The triple surgery of trabeculectomy combined with ECCE and IOL implantation is effective and economic therapeutic method. It is worth of being spread.