表麻下超声乳化人工晶状体植入联合小梁切除治疗青光眼合并白内障

Phacoemulsification and intraocular lens implantation combined with trabeculectomy on the management of glaucoma and coexisting cataract under topical anesthesia

目的:评价表面麻醉下超声乳化人工晶状体植入联合小梁切除治疗青光眼合并白内障的临床疗效。方法:对45例45眼青光眼合并白内障患者施行在表面麻醉下超声乳化及人工晶状体植入联合小梁切除术,观察临床效果。结果:术后矫正视力0.1～0.3者12眼(27%),0.4～0.6者23眼(51%),0.7～1.0者10眼(22%)。43眼眼压降至正常,仅2眼眼压高于正常值,经局部滴药后降至正常。术后随访6～18mo,术后并发症是角膜水肿、浅前房、虹膜炎症,以上并发症经药物治疗均恢复正常。结论:表面麻醉下白内障超声乳化人工晶状体植入联合小梁切除术在治疗青光眼合并白内障的患者时,能够有效恢复视力和控制眼压。

AIM：To evaluate the clinical efficacy of phacoemulsifi-cation and intraocular lens implantation combined with trabeculectomy for glaucoma and coexisting cataract under topical anesthesia.METHODS：Under topical anaesthesia,phacoemulsification and intraocular lens implantation combined with trabeculectomy were done in 45 cases 45 eyes of glaucoma and coexisting cataract,and the clinical effect was observed.RESULTS：Postoperative best-corrected visual acuity was 0.1-0.3 in 12 eyes（27%）,0.4-0.6 in 23 eyes（51%）,0.7-1.0 in 10 eyes（22%）.The postoperative intraocular pressure（IOP） was normal in 43 cases,only IOP of two cases were higher than normal recovered to normal after local dropping of drug.The main postoperative complications included corneal edema,shallow anterior chamber and iritis.The follow-up after surgery was from 6 to 18 months,all the complications were normal after drug treatment.CONCLUSION：Under topical anesthesia,phacoemulsification and intraocular lens implantation combined with trabeculectomy is an effective method to restore vision and control IOP in treating glaucoma and coexisting cataract.