孤眼青光眼术后白内障粘连性小瞳孔超声乳化术

Efficacy of phacoemulsification surgery in cataract patient with adhesive microcoria in solitary eye after glaucoma surgery

目的探讨孤眼（另眼已盲且无法复明者）患者抗青光眼术后白内障粘连性小瞳孔超声乳化手术的临床效果。方法孤眼抗青光眼术后白内障粘连性小瞳孔43例（43眼），进行超声乳化手术。比较分析术前、术后1周及术后3个月眼压及视力变化情况，及术后并发症。结果与术前相比，术后1周及3个月眼压≤21mmHg（1mmHg=0．133kPa）的比率提高，眼压〉21mmHg的比率及平均眼压均降低，差异具有统计学意义（P〈0．05）。与术前相比，术后1周及术后3个月视力均有所改善，其中术后1周视力〉0．5的比率及术后3个月视力0．3～0．5及〉0．5的比率均提高，术后3个月视力〈0．05的比率及视力0．05～0．25的比率均降低，差异具有统计学意义（P〈0．05）。全组43例术后均无严重并发症发生。结论超声乳化术治疗孤眼患者抗青光眼术后粘连性小瞳孔白内障手术风险较大，但经术前精心准备，手术细心操作及妥善的术后处理，术后眼压明显降低，视力明显提高，且无严重并发症发生，临床效果较好。

Objective To investigate the clinical efficacy of phacoemulsification on eyes with adhesive microcoria after anti-glaucoma surgery in cataract patient with solitary eye. Methods 43 cataract patients （43 eyes） with solitary eye were treated with phacoemulsification surgery for adhesive mierocoria after anti-glaucoma surgery. The intraoeular pressure and visual acuity before surgery and one week and three months after surgery were compared and analyzed. Results Compared with the intraocular pressure before surgery, one week and three months after surgery, the ratio of intraocular pressure at ~〈21 mmHg was in- creased significantly,the ratio of intraoeular pressure 〉 21mmHg and average intraocular pressure were de- creased significantly, and there were statistically significant difference （P 〈 0.05 ）. Compared with the visu- al acuity before surgery, one week and three months after surgery, the visual acuities were all improved. One week after surgery, the ratio of visual acuity at 〉 0.5 increased. Three months after surgery, the ratio of visual acuity at 0.3 - 0.5, and at 〉 0.5 were improved significantly. Three months after surgery, the ratio of visual acuity at 〈 0.05 and 0.05 - 0.25 was reduced significantly, and there were statistically significant differences （ P 〈 0.05 ）. There were no serious postoperative complications in 43 cases. Conclusion The adhesive microeoria cataract patients with solitary eye can be treated by phaeoemulsification with high surgery risk. With good preoperative preparation, careful intraoperative operation and proper postoperative treatment, the intraoeular pressure decreased and visual acuity was improved significantly and no serious complication happened. It has satisfactory clinical results.