小切口白内障超声乳化联合隧道内小梁切除术治疗青光眼合并白内障的疗效分析

Clinical effect of small incision phacoemulsification combined with trabeculectomy in tunnel in the treatment of glaucoma with cataract

目的探讨小切口白内障超声乳化联合隧道内小梁切除术治疗青光眼合并白内障的临床疗效。方法选择青光眼合并白内障患者36例（38眼），行2．8mm小切口白内障超声乳化吸除折叠式IOL植入联合隧道内小梁切除术，观察术前和术后视力、眼压、角膜散光度变化及手术并发症。结果患者术后视力均有提高，术后1周视力≥0．4者29眼（76．32％）。随访3～6个月，全部患者术后眼压有效控制，术后1周眼压[（12．24±3．59）mmHg（1mmHg=0．133kPa）]及术后3～6个月眼压[（15．53±5．26）mmHg]较术前眼压[（36．72±4．34）mmHg]明显降低，差异有统计学意义（P〈0．05）。不同时期角膜散光度比较差异无统计学意义（P〉0．05）。结论小切口白内障超声乳化联合隧道内小梁切除术可有效改善青光眼合并白内障患者的眼压及视力。

Objective To explore the clinical effect of small incision phacoemulsification combined with trabeculectomy in tunnel in the treatment of glaucoma with cataract. Methods Thirty-six cases （38 eyes） who performed 2.8 mm small incision phacoemulsification combined with trabeculectomy in tunnel were enrolled in this study. The visual acuity, intraocular pressure （IOP）, astigmatism and complications were assessed before and after operation. Results The visual acuity≥ 0.4 was in 29 eyes （76.32%） postoperatively. After followed up 3-6 months, the IOP of all the patients had been effectively controlled. The IOP at 1 week[ （ 12.24 ± 3.59） mm Hg（ 1 mm Hg = 0.133 kPa） ] and 3-6 months[ （ 15.53 ±5.26） mm Hg] after operation was significantly lower compared with before operation [ （36.72 ± 4.34） mm Hg ] （P 〈 0.05 ）. There was no significant difference in astigmatism among before operation, 1 month and 3-6 months after operation （P 〉 0.05）. Conclusion Small incision phacoemulsification combined with trabeculectomy in tunnel is an effective surgery for glaucoma with cataract, which can improve visual acuity and IOP.