超声乳化人工晶体植入联合巩膜瓣下纵形角巩膜条切除治疗青光眼合并白内障

Phacoemulsification,intraocular lens implantation and radical lamellar scleractomy under flap for treatment of glaucoma with cataract

目的 :评价超声乳化、人工晶体植入联合巩膜瓣下纵形角巩膜条切除术 (联合手术 )治疗青光眼合并白内障的手术效果。方法 :2 3例患者接受了联合手术治疗。完成了结膜瓣和巩膜瓣之后 ,经过 3.2 mm的遂道切口超声乳化白内障 ,然后扩大切口至5 .5 mm。向囊袋内植入 PMMA人工晶体 ,再纵形切除包括小梁在内的 2 mm× 4mm角巩膜条。结果 :术后随访 3～ 2 1个月。平均9.7个月 ,视力显著提高 ,在 0 .3以上的占 6 0 .7% ,眼压均控制在 2 .8k Pa以下 ,仅 2例需用一种降压药物 ,术中 2例出现睫状体表面出血 ,1例出现后囊膜破裂 ,1例术后第一天出现轻度前房出血 ,远期无严重并发症。结论 :联合手术治疗青光眼合并白内障视力恢复快 ,降压效果好 ,并发症少 。

To evaluate therapeutic effects of phacoemulsification,intraocular lens(IOL)insertion,and radical lamellar scleractomy under flap(combinded procedures)for treatment of glaucoma with cataract.Methods:23 cases received combined procedures.Phacoemulsification was performed through 3 2mm limbus tunnel incision,IOL was inserted in in-bag fixation and incised 2mm×4mm radical lamellar scleractomy under fiap.Rerults:Follow-up was 3～21 monthes,means 9 7monthes.Corrected visual acuity was in 0 3 or better in 60 7% of eyes,averaged IOP decreased less than 2 8kPa,and one antiglaucoma medication was applicated in 2 cases.2 cases had hyphemas intraoperatively.Posterior capsular rupture occured in 1 case,and hyphema in anterior chamber occurred in 1 case 1 day postoperatively.Conclusion:Combined procedures have features of rapid visual acuity restoration,better IOP decline and less complication.