联合手术治疗青光眼合并白内障的临床观察

Clinical observation on the phaco-emulsification and intraocular lens implantation combined with trabecul-ectomy inside the tunnel for treatment of glaucoma with cataract

目的:探讨治疗青光眼合并白内障的手术方法及临床效果。方法:对45例45眼青光眼合并白内障患者施行白内障超声乳化及人工晶状体植入联合隧道内小梁切除术。结果:术前视力<0.1者32眼,0.1～0.3者13眼。术后视力<0.1者6眼(13%),0.1～0.5者22眼(49%),>0.5者17眼(38%)。术前眼压26～60mmHg,术后42例眼压降至正常范围,3例经局部按摩、滴药后降至正常,平均眼压12.78±2.70mmHg。随访6～12mo,无1例眼压再升高。3例视力下降,经戴镜矫正视力提高。并发症主要是角膜水肿和虹膜炎症反应。结论:白内障超声乳化人工晶状体植入联合隧道内小梁切除术是治疗青光眼合并白内障的理想方法。

AIM：To discuss the treating method and the clinical efficacy on combined surgery of glaucoma with cataract.METHODS：Phacoemulsification and intraocular lens implantation combined with trabeculectomy inside the tunnel was performed on 45 cases（45 eyes） of glaucoma with cataract.RESULTS：There were 32 eyes of which the preoperative visual acuity was﹤0.1,0.1- 0.3 in 13 eyes.There were 6 eyes （13%）of which the postoperative visual acuity was0.1,0.1- 0.5 in 22 eyes （49%）,0.5 in 17 eyes（38%）.The postoperative IOP was normal in 42 cases.The average value of IOP was 12.78±2.70mmHg.The main postoperative complications included corneal edema and iritis.The follow-up after surgery was 6-12 months.No case of IOP increased.Visual acuity declined in 3 cases.CONCLUSION：The phacoemulsification and intraocular lens implantation combined with trabeculectomy inside the tunnel is an ideal method in treating glaucoma with cataract.