小切口手法非超乳三联术治疗青光眼合并白内障

Combining Surgical Procedures of Cataract and Glaucoma with Small Incision Cataract Extraction,Intraocular Lens Implantation and Trabeculectomy

目的观察小切口手法非超乳白内障摘出人工晶体植入联合小梁切除术(以下简称三联术)治疗青光眼合并白内障的疗效。方法对38例(41眼)治疗青光眼合并白内障行联合手术,术后随访3～9月,观察视力、眼压、滤过泡及并发症情况。结果视力>0.3者32眼(77.78%),眼压<20 mm Hg者38眼(95.12%),其中3例(3眼)术后眼压在25 mm Hg左右,滴用0.5%噻吗酰胺滴眼液后眼压得到控制,功能性滤过泡(Ⅰ型、Ⅱ型)37眼(90.24%),无严重并发症发生。结论三联术是目前治疗青光眼合并白内障较好的手术方法,不仅能很好地控制眼压,迅速恢复视功能,并发症少,手术安全,经济有效,而且不需要昂贵的超声乳化设备,简单易行容易掌握,远期疗效良好。

Objective To observe the effect of combined surgery of impro^ed small incision cataract extraction, intraocular lens （IOL） implantation and trabeculectomy on the treatment of cataract and Glaucoma. Methods Combined surgery were performed on 38 case（41 eyes） of cataract with Glaucoma. The postoperative visual acuity intraocular pressure,filtering bleb and complica- tions investigated after follow-up of 3 to 9 months. Results 32 eyes had the best corrected visual acuity 〉 0.3 （77.78%）, 38 eyes（92.69% ） had the lOP 〈 20 mm Hg,2 cases（3 eyes） IOP were about 25 mm Hg postoperatively and could be controlled in normal range by 0.5% timolol. 37 eyes（90.24% ） had the functional filtering belt（ including I and l] type） ,all case had no se- vere complications. Conclusion The combined surgery was a best technique to therapy cataract with glaucoma by controlling lOP effectively and restoring visual acuity early with less complication. It need not expensive phacoemulsification equipment and easy to grasp. The long-term curative effect is best.