晶状体摘出术治疗原发性闭角型青光眼的研究进展

The advances of lens extraction for primary angle closure glaucoma

晶状体的形态和位置改变所引起的浅前房、瞳孔阻滞及房角关闭是诱发原发性闭角型青光眼（PACG）的因素之一。晶状体摘出术可以增加前房深度，解除瞳孔阻滞；而晶状体摘出术联合房角分离术可使关闭的房角重新开放，防止周边房角前粘连。近年来采用晶状体摘出术治疗PACG的研究取得较大进展，而其作用机制的研究、治疗效果的评价及仍然存在的问题等日益受到关注。就PACG的发生和发展与晶状体改变的关系、晶状体摘出术在治疗PACG中的作用、效果及手术的安全性评价等进行综述。

Development of primary angle closure glaucoma（PACG） is closely related to the changes of the position and morphology of the lens owing to a shallow anterior chamber, pupillary blockage and angle closure. Lens extraction can deepen the depth of the anterior chamber and resolve the pupillary blockage,and therefore increase the outflow of aqueous fluid. Furthermore,the combination of lens extraction with goniosynechialysis can reopen the closed anterior chamber angle and relieve peripheral anterior synechia of pupil,with a better clinical effectiveness for primary angle closure glaucoma. Recently, the studies related to lens extraction for primary angle closure glaucoma have made great progression, especially its mechanism and efficacy, and of course some existing problems of lens extraction are concerned. In this review, the relationship between lens and primary angle closure glaucoma, the clinical effectiveness of lens extraction for primary angle closure glaucoma, the safety evaluation of lens extraction and goniosynechialysis were summarized.