白内障超声乳化联合房角分离术治疗原发性慢性闭角型青光眼

Clinical study on the management of chronic angle-closure glaucoma by phacoemulsification for cataract surgery combined with lysis of the synechiae

目的:探讨超声乳化白内障吸除及人工晶状体植入术联合房角分离术治疗原发性慢性闭角型青光眼的疗效。方法:采用白内障超声乳化及人工晶状体植入联合房角分离术治疗合并白内障的原发性慢性闭角型青光眼32例32眼,比较手术前后的眼压、视力、前房深度、房角形态,观察术后并发症等情况。结果:术后随访6mo～2a;所有病例术后最佳矫正视力均提高;术后眼压明显降低,术前平均眼压15.2±8.1mmHg,术后11.2±5.0mmHg,差异有显著统计学意义(t=3.126,P<0.01);术后中央前房深度显著加深,术前平均中央前房深度2.22±0.39mm,术后3.36±0.43mm,差异有显著统计学意义(t=-14.371,P<0.01);术后房角粘连范围有减少,无严重并发症出现。结论:白内障超声乳化房角分离术能有效的治疗并发白内障的原发性慢性闭角型青光眼。

· AIM： To investigate the clinical effect and indication of phacoemulsification combined with lysis of the synechiae in the management of chronic angle-closure glaucoma with cataract. METHODS. The 32 patients were treated by phacoemulsification combined with lysis of the synechiae. The preoperative and postoperative intraocular pressure, visual acuity, anterior chamber depth, configuration of anterior chamber were compared; the postoperative complications were observed. · RESULTS： The mean postoperative follow-up duration was 6 months to 2 years. The best-corrected visual acuity was improved in all eyes. The intraocular pressure was reduced from15.2±8.1 mmHg to 11.2±5.0mmHg, the difference had statistical significance（ t= 3. 126, P〈0.01 ）. The central anterior chamber deepened from 2. 22 ± 0.39mm preoperatively to 3.36±0.43mm postoperatively, the difference had statistical significance （ t= -14. 371, P〈 0. 001 ）. The chamber adhesion range reduced. The serious complications did not happened. · CONCLUSION： Phacoemulsification combined with goniosynechialysis is an effective and safe treatment for primary chronic angle-close glaucoma with cataract.