青光眼小梁切除术后白内障超声乳化人工晶状体植入术临床分析

Clinical evaluation of phacoemulsification and intraocular lens implantation for cataract after trabeculectomy

目的:分析青光眼小梁切除术后并发性白内障超声乳化联合软性人工晶状体植入的临床效果。方法:青光眼小梁切除术后白内障患者132例148眼,行鼻上或颞上象限角膜遂道切口或巩膜隧道切口白内障超声乳化吸除人工晶状体植入术,术后随访3～39mo,观察术后视力、眼压及并发症。结果:患者132例148眼术后视力恢复较满意,术后1wk矫正视力<0.05者8眼(5.4%),0.05～0.3者26眼(17.6%),～0.6者72眼(48.6%),～1.0者40眼(27.0%),>1.0者2眼(1.4%)。手术后眼压稳定,平均眼压15.23±3.42mmHg(1mmHg=0.133kPa)。手术并发症为早期角膜水肿及虹膜反应,均较轻,2～5d内消退。结论:经小切口超声乳化手术治疗青光眼小梁切除术后并发性白内障,操作简便,术后恢复快,散光小,并发症少,眼压控制好,在对青光眼术后并发性白内障的复杂情况方面似有优越之处。

AIM： To evaluate the results of phacoemulsification combined with soft intraocular lens implantation in the treatment of cataract after trabeculectomy . METHODS：In total of 132 patients 148 eyes with cataract after trabeculectomy were treated by phacoemulsification and intraocular lens implantation in nasal or superior temporal quadrant incisions. Visual acuity, intraocular pressure （IOP） and complications were assessed in the postoperation. The follow-up time was from 3 to 39 months. RESULTS： All 148 eyes of 132 patients acquired satisfied visual acuity. One week postoperatively, the corrected visual acuity（CVA） showed that 8 eyes （5.4%） were〈005, 26 eyes （17.6%） were≥0.05-0.3, 72 eyes （486%） were〉0.3-0.6, 40 eyes （27.0%） were〉0.6-1.0,2 eyes （14%） were〉1.0. The intraocular pressure （IOP） was all stable after the operation（15.23±342mmHg, 1mmHg=0.133kPa）.The main complications were early postoperative corneal edema and iris reaction which were mild and faded away in 2-5 days. CONCLUSION： The small incision phacoemulsification combined with intraocular lens implantation is convenient and effective for the treatment of cataract after trabeculectomy. It has achieved rapid postoperative recovery, less complication, lower astigmatism and stable IOP. The operation is better than extracapsular cataract extraction （ECCE） method in the treatment of cataract after trabeculectomy.