早期原发性闭角型青光眼合并白内障的手术治疗

Surgery in early primary angle-closure glaucoma with cataract

目的:研究白内障超声乳化联合后房型人工晶状体植入术在合并白内障的早期原发性闭角型青光眼的应用安全性和有效性。方法:将合并白内障的早期原发性闭角型青光眼患者随机分为两组,一组行激光周边虹膜切开术(周切组),另一组行超声乳化白内障摘除联合后房型人工晶状体植入术(超声乳化组);分析治疗前后的眼前段结构的变化,比较治疗前后视力及眼压;随访时间为3mo。结果:激光组及超声乳化组的患者在治疗后都发生不同程度的周边前房加深、房角加宽;而激光组术后视力无提高、前房轴深较术前无变化,少部分房角加宽不明显。超声乳化组术后视力明显提高、前房轴深加深,房角均加宽,已经粘连关闭的房角也部分重新开放。结论:超声乳化白内障摘除联合后房型人工晶状体植入术在合并白内障的早期原发性闭角型青光眼的应用安全,能有效控制青光眼的发生及发展,对于虹膜高褶构型的患者同样有效,同时能改善视力。

AIM：To study the safety and efficacy of phacoemulsification and intraocular lens implantation in early primary angle-closure glaucoma with cataract. METHODS：Early primary angle-closure glaucoma patients with cataract were divided into two groups randomly, one group was treated with laser peripheral iridotomy, the other group was treated with phacoemulsification and intraocular lens implantation. Intraocular pressure and eye sight were compared after surgery, the follow-up was 3 months. RESULTS：Both groups could have results of deeper peripheral anterior chamber and wider anterior chamber angle in different extend, however, patients in laser group didn＇t have their eyesight improved, patients in phaco group had obvious eye sight improvement, and anterior chamber angle widened in all the patients, some peripheral angle synechia reopened after surgery. CONCLUSION： Phacoemulsification and intraocular lens implantation is safe in early primary angle-closure glaucoma with cataract, is equally effective in plateau iris configuration, and can improve eyesight at the same time.