改良小梁切除术联合超声乳化人工晶状体植入术治疗青光眼合并白内障

Improved trabeculectomy combined with phacoemulsification,intraocular lens implantation for glaucoma and cataract

目的观察改良小梁切除术联合超声乳化人工晶状体植入术治疗青光眼合并白内障的临床疗效。方法选取我院2010年1月至2011年6月青光眼合并白内障患者60例(60眼),均行改良小梁切除术联合超声乳化人工晶状体植入术。随访3～6个月,观察患者随访末期的视力、眼压、滤过泡及并发症情况。结果 60例(60眼)患者术前视力<0.1者30眼,0.1～<0.3者18眼,0.3～0.5者12眼;术后至随访末期,除2眼因眼内炎致视力丧失外,其余患者视力均有不同程度提高,其中视力<0.1者9眼,0.1～<0.3者16眼,0.3～<0.5者20眼,0.5及以上者15眼;术前、术后比较差异有统计学意义(P<0.05)。术后眼压为(14.58±2.32)mmHg(1kPa=7.5mmHg),与术前(29.08±7.59)mmHg相比,差异有显著统计学意义(P<0.01)。术中出现晶状体后囊膜破裂2眼,均未出现玻璃体脱出等其他并发症;术后出现角膜水肿24眼,眼内炎2眼,不同程度前房纤维素样渗出8眼,浅前房6眼。结论改良小梁切除术联合超声乳化人工晶状体植入术治疗青光眼合并白内障可降低眼压、改善视力,且并发症少。

Objeetive To observe the curative effect of improved trabeculectomy combined with phacoemulsification,intraocular lens implantation for glaucoma and cat- aract. Methods Sixty patients （60 eyes） with glaucoma and cataract in our hospital from January 2010 to June 2011 were chosen, and all patients received improved trabe- cuiectomy combined with phacoemulsification, intraocular lens implantation. The fol- low-up time was from 3 months to 6 months,the visual acuity,intraocular pressure,fil- tering bleb and complication were observed. Results The preoperative visual acuity in 60 patients （60 eyes） was less than 0.1 in 30 eyes,from 0. 1 to less than 0.3 in 18 eyes ,from 0. 3 to less than 0.5 in 12 eyes;At the final follow-up time ,the visual acuity in 2 eyes were lost due to endophthalmitis, other eyes were improved to certain degrees,in which less than 0.1 in 9 eyes, from 0. 1 to 0.3 in 16 eyes, from 0.3 to 0.5 in 20 eyes, more than 0.5 in 15 eyes ,there was statistical difference compared with that before op-eration （P 〈 0.05 ）. The postoperative intraocular pressure was （ 14.58 ± 2.32 ） mmHg （ 1 kPa = 7.5 mmHg）, compared with that before operation （ 29.08 ± 7.59） mmHg, there was significant difference （P 〈 0.01 ）. The posterior capsule of lens rup- tured in 2 eyes in the operation, no prolapse of vitreous occurred. The postoperative complications included corneal edema in 24 eyes, endophthalmitis in 2 eyes, anterior chamber fiber exudation with various degrees in 8 eyes and shallow anterior chamber in 5 eyes. Conclusion Improved trabeculectomy combined with phacoemulsification,intraocular lens implanta- tion for glaucoma and cataract can decrease the intraocular pressure and improve the visual acuity with less complications.