改良切口在非超声乳化白内障青光眼联合手术的临床应用

Clinical Application of Modified Incision Phacoemulsification Cataract Surgery, Glaucoma Combined

目的探讨采用改良的巩膜瓣联合巩膜隧道切口施行非超声乳化白内障青光眼联合手术治疗青光眼合并白内障的临床效果。方法对45例(45眼)青光眼并发白内障的患者采用改良的巩膜瓣联合巩膜隧道切口施行非超声乳化白内障摘除人工晶体植入联合小梁切除术,术后随访观察视力、眼压、滤过泡、前房、人工晶体位置等情况。结果 41眼视力比术前有不同程度提高。指数者3眼,<0.1者2眼,0.1～0.3者13眼,0.3以上者24眼,眼压均在正常范围,平均眼压为(13.25±3.10)mmHg(1mmHg=0.133kPa)。结论采用改良的巩膜瓣联合巩膜隧道切口施行非超声乳化白内障青光眼联合手术,术后能获得良好的视力恢复与眼压控制,手术时间短,手术操作易于掌握,术中并发症少,手术费用低,适合开展。

Objective To evaluate the clinical effect of modified scleral valve combined with scleral tunnel incision nonphacoemulsification cataract surgery combined with trabeculectomy. Methods Forty-five eyes of 45 patients with glaucoma and cataract were treated with nonphacoemulsification cataract surgery combined with trabeculectomy under modified scleral valve combined with scleral tunnel incision .Visual acuity, intraocular pressure ,filtering bleb,the anterior chamber depth and the position of intraocular lens were observed after the surgery. Results Forty-one patients achieved better visual acuity（finger count in 3 eyes,〈0.1 in 2 eyes,0.1 to 0.3 in 13 eyes and 〉0.3 in 24 eyes）and the mean postoperative intraocular pressure was （13.25~ 3.10）mmHg（lmm Hg=0.133kPa）o Conclusions Modified scleral valve combined with scleral tunnel incision nonphacoemulsification cataract surgery combined with trabeculectomy is an effective way in improving visual acuity and reducing intraocullar pressure ,the time of surgery is short ,surgery operation is easy to be grasp,the less complication,the less expensive PMMA IOL can be used.