晶状体摘除联合房角分离治疗高眼压状态下急性闭角型青光眼的临床观察

Joint phacoemulsification and goniosynechialysis to treat acute angle closure glaucoma

目的观察晶状体摘除联合房角分离治疗高眼压状态下急性闭角型青光眼的临床疗效。方法回顾性分析我院收集的19例(22只眼)急性闭角型青光眼(经常规降压处理仍处于高眼压状态下)患者,施行白内障超声乳化联合人工晶状体植入联合房角分离术,检查患者术前及术后的视力、眼压、中央前房深度(ACD)及前房角。结果患者的术前平均视力为0.17±0.23,术后为0.33±0.25,术后视力明显提高(P<0.05);术后眼压(14.95±2.70)mm Hg,术前眼压为(39.86±12.38)mm Hg,术前术后相比差异有统计学意义(P<0.05);术前ACD(2.32±0.67)mm,术后ACD(2.95±0.23)mm,两者相比有显著差异(P<0.05);术前术后前房角相比有明显统计学意义(Z=-4.701,P<0.05)。结论晶状体摘除联合房角分离术后患者视力明显优于术前,此术式可以明显降低眼压,加深前房深度,增宽前房角,是治疗高眼压状态下急性闭角型青光眼的安全可靠的方法。

Objective To evaluate the clinical efficacy of joint phaccemulsification and gouiosynechialysis to treat acute angle closure glaucoma. Methods This is a retrospective study. We reviewed the medical history of 19 patients （ 22 eyes ） with acute angle closure glaucoma that were treated with joint phacoemulsification and goniosynechialysis in our hospital. Visual acuity, intracular pressure （IOP）, central anterior chamber depth and anterior chamber angle before and after surgery were reviewed and analyzed. Results Visual acuity improved significantly from 0.17 ±0. 23 to 0. 33 ± 0. 25（P 〈0.05）, as well IOP from （39.86 ± 12.38） mm Hg preoperatively to （ 14.95 ±2.70） mm Hg postoperativdy （ P 〈 0. 05 ）. Anatomically, central anterior chamber depth increased from （ 2. 32 ± 0. 67 ）mm to （ 2. 95 ± 0. 23 ） nun （ P 〈 0.05）, and anterior chamber angle increased significantly as well （ z = -4.701, P 〈0.05）. Conclusion Joint phacoemulsification and gouiosynechialysis reduces IOP significantly t increases anterior chamber depth and opens the anterior chamber angle. The procedure is an effective treatment for acute angle closure glaucoma.