超声乳化治疗白内障合并闭角型青光眼的临床体会

Clinical experience of phacoemulsification for cataract patients with angle-closure glaucoma in 29 cases

目的:观察超声乳化白内障摘除折叠人工晶状体植入术治疗白内障合并闭角型青光眼的临床效果。方法:对29例29眼闭角型青光眼合并有白内障的患者行超声乳化白内障摘除折叠人工晶状体植入术,并对术后视力、眼压、前房角镜检查及并发症进行统计分析。结果:患者28眼(96.5%)术后视力提高。25眼(86.2%)不需要用任何降眼压药物,眼压均维持在正常水平,3眼(10.3%)局部应用抗青光眼眼药水眼压控制正常,1眼(3.5%)行小梁切除术后眼压恢复正常。29眼房角镜检查房角较术前增宽。8例(27.6%)术后早期出现轻度角膜水肿,经治疗恢复正常。结论:对合并白内障的原发性闭角型青光眼,术前房角粘连关闭≤270°者,可以考虑先行白内障超声乳化联合折叠人工晶状体植入术,可有效降低眼压,开放房角,提高视力,治疗效果良好。

AIM： To observe the clinical effect of phacoemulsification with foldable intraocular lens implantation on cataract with angle-closure glaucoma. METHODS： Twenty-nine cases （ 29 eyes ） of angle-closure glaucoma with cataract underwent phacoemulsification with foldable intraocular lens implantation, and the data of visual acuity, intraocular pressure, gonioscopy and complications after operation were statistically analyzed. RESULTS：Postoperatively, 28 eyes （ 96. 5%） visual acuity were improved. Intraocular pressure of 25 eyes （86. 2%） were maintained at a normal level without any IOP lowering drug, intraocular pressure of 3 eyes （10.3%） were controlled by IOP lowering eye drops, intraocular pressure of 1 eye（3. 5%） returned to normal by trabeculectomy. The chamber depth of 29 eyes was increased. 8 eyes were suffered from mild corneal edema, and returned to normal after treatment. CONCLUSION：Characterized by decreasing intraocular pressure, opening anterior chamber, and raising visual acuity, phacoemulsification with foldable intraocular lens implantation is a good operative therapy for primary angle-closure glaucoma complicated with cataract with preoperative goniosynechia closed ≤270°.