缩瞳后前房角的形态与青光眼手术方式的选择

Surgical management of coexisting glaucoma and cataract based on the gonioscopic examination

目的探讨根据缩瞳后前房角形态选择原发性慢性闭角型青光眼并白内障的手术方式的意义。方法37例（37眼）缩瞳后前房角粘连闭合≤180°者，行超声乳化术；前房角粘连闭合〉180°者，行超声乳化联合小梁切除术。术后观察3个月。结果21例行超声乳化吸出人工晶状体植入术，16例行超声乳化吸出人工晶状体植入联合小梁切除术。各组均有1例术后眼压高，滴降眼压约物可控制。结论缩瞳后前房角形态检查有助于选择慢性闭角型青光眼并白内障的手术方式。

Objective To investigate the clinical efficacy of surgical management of coexisting glaucoma and cataract based on the morphology of anterior chamber angle under gonioscopy after using mio- tics. Methods Thirty-seven eyes of 37 cases of glaucoma combined with cataract were enrolled in the stud- y. All cases were examined by gonioscopy after using miotics. The cases with syneehia less than 180° were treated by phaeoemulsifieation. The other cases with synechia over 180° were treated by phaeoemulsification and trabeculectmny. The postoperative intraocular pressure （lOP） and visual acuities were analyzed. Re- sults The follow up was 3 months. 21 cases （group A） were treated by phaeoemulsification cataract extra- tion and intraoeular lens implantation. Phacoemulsification combined with trabeculectomy was performed in 16 cases （group B）. There was one ease with high IOP in each group, respectively. These two cases＇ IOP could be eontrolled by medication. Conclusion Gonioscopic examination after using miotics is helpful for the choice of surgical procedure in the management of coexisting glaucoma and cataract.