超声乳化联合房角粘连分离术治疗慢性闭角型青光眼合并白内障

Phacoemulsification combined with goniosynechialysis in the management of chronic primary angle-closure glaucoma

目的:探讨白内障超声乳化联合前房角粘连分离术治疗慢性闭角型青光眼合并白内障的临床疗效。方法:分析2008-01/2011-01在我科住院治疗的慢性闭角型青光眼合并白内障患者57例57眼,施行白内障超声乳化后房型人工晶状体植入联合前房角粘连分离术,随访8～15(平均10.8)mo,观察眼压、房角、最佳矫正视力、中央前房深度的变化。结果:术后52眼无需加用降眼压药物,眼压<21mmHg。另4眼随访期内加用1种降眼压药物(10g/L布林佐胺滴眼液)后,眼压<21mmHg,1眼加用2种降眼压药物(10g/L布林佐胺滴眼液和5g/L噻吗洛尔滴眼液)后,眼压<21mmHg;全部患者术后房角开放;除1例术前明显视神经萎缩病例术后视力无提高,其余病例术后视力提高两行或以上;术后中央前房深度3.35±0.54mm,较术前(2.01±0.05mm)明显加深。结论:对于慢性闭角型青光眼合并白内障,白内障超声乳化后房型人工晶状体植入联合前房角粘连分离术是一种安全有效的方法,患者不仅视力明显提高,而且远期眼压也能得到有效控制。

AIM ： To investigate the clinical effects of phacoemulsification combined with goniosynechialysis in the management of chronic primary angle- closure glaucoma （ CPACG）. METHODS：Totally 57 cases （57 eyes） with CPACG and cataract were treated with phacoemulsification combined with goniosynechialysis. Intraocular pressure （lOP）, anterior chamber angle, best-corrected visual acuity and central anterior chamber depth were monitored during follow-up for 8-15 months in these eyes. RESULTS： The lOPs of 52 eyes were normal without any medications. The lOPs of 4 eyes were normal with a single antiglaucomatous eye drops. The lOP of 1 eye was normal with two kinds of antiglaucomatous eye drops. The anterior chamber angles became wider and the synechial angle closure were reopened after surgery in all eyes. The best-corrected visual acuity were improved except 1eye with optic atrophy. The postoperative central anterior chamber depth became deep. CONCLUSION.. Phacoemulsification combined with goniosynechialysis is able to safely effectively control lOP and also improve the visual acuity of CPACG.