表面麻醉下小切口手法碎核青光眼白内障联合手术的疗效观察

Clinical observation of the operation on glocoma combined with cataract by manual nucleus division under surface anesthesia

目的评价表面麻醉下小切口手法碎核人工晶状体植入联合小梁切除术的临床效果。方法对2008年6月至2011年12月26日26例(34只眼)青光眼合并白内障,在0.4%奥布卡因表面麻醉下行小切口手法碎核白内障摘除人工晶状体植入联合小梁切除术,观察麻醉效果及术后情况。结果有5只眼在缝合球结膜时有疼痛感需加滴一次麻药,其余患者术中均能很好配合。随诊3～12个月,术后16只只眼(47.06%)视力大于0.3,影响术后视力的主要原因是眼底病变,32只眼眼压在20 mm Hg以下,平均眼压15.50 mm Hg,视野无进行性损害,无严重并发症。结论表面麻醉下小切口手法碎核白内障摘除人工晶状体植入联合小梁切除术安全、有效、方便。

Objective To appraise the clinical effect of small incision cataract extraction with intraocular lens implanation combined with trabeculectomy. Methods 34 eyes of glaucoma with cataract underwent the extracapsular cataract extraction with intmocular lens implanation and trabeculectomy under surface of 0.4% oxybuprecaine ,anesthesia effect and postoperative situation were observed. Results Five eyes felt pain and need adding a drop of anesthesic when suturing inci- sion ,others all can cooperate well. All cases were followed up for 3 - 12 months, vision was better than 0.3 in 16 of 34 eyes （47.06%）. Primary cause of influencing vision was fundus lesions. Intmocular pressure was controlled in normal rang （ 〈 =20 nun Hg） in 32 eyes ,average was 15.50 mm Hg ,there was no progressive destruction on visual field and serious compication. Conclusion The surgery of smal incion cataract extraction with IOL impanation combined with trabeculecto- my was safe, well effective and convenient.