隧道式巩膜瓣白内障青光眼联合手术的新方法

A clinical investigation on scleral tunnel flap small-incision cataract extraction combined with trabeculectomy.

目的 探讨小切口白内障摘出联合隧道式巩膜瓣小梁切除术治疗青光眼合并白内障的效果。方法 应用小切口白内障摘出联合隧道式巩膜瓣小梁切除术对 46例 47眼青光眼合并白内障进行手术治疗。术后随访观察视力、眼压、滤过泡及并发症等。结果 术前眼压平均 ( 2 4 35± 3 64 )mmHg( 1mmHg =0 133kPa) ,术后眼压平均为 ( 14 70± 2 49)mmHg ,较术前平均降低 9 65mmHg ,差异有显著性意义 (P <0 0 0 1) ,仅两例眼压高于正常 ,药物可控制。术前视力全部低于 0 3,术后视力大于 0 5者 61 7%。结论 小切口白内障摘出联合隧道式巩膜瓣小梁切除术具有降压疗效好、恢复快、并发症少等优点 ,效果较为理想。

Objective To evaluate the effectiveness of scleral tunnel flap trabectomy combined with small-incision cataract extraction in patients with coexisting glaucoma and cataract.Methods Forty-six patients(47 eyes) with coexisting glaucoma and cataract underwent scleral tunnel flap small-incision cataract extraction and postoperative IOP, visual acuity, filtering bleb and complications were investigated.Results The mean preoperative intraocular pressure (IOP) was (24.35±3 64) mmHg(1 mmHg=0 133 kPa) which decreased to a mean postoperative IOP of (14.70±2 49)mmHg with a mean pressure reduction of 9.65 mmHg not including two cases' IOP which was high than mormal.The preoperative visual acuities in all eyes were<0 3. Postoperatively, the visual acuities were >0 5 (61 7%).Conclusion Scleral tunnel flap small-incision cataract extraction combined with trabeculectomy appears effective for treating selected patients with coexisting cataract and glaucoma, improving the valid visual acuity rapidly, reducing intraocular pressure and having less postoperative complications.