早期白内障超声乳化吸除术治疗可疑房角关闭初步探讨

Early cataract phacoemulsification surgery for the treatment of a preliminary study of the primary angle-closure suspect

目的探讨可疑房角关闭进行早期白内障超声乳化吸除术的可行性、安全性、手术疗效及患者的收益比。方法对2008年5月至2010年1月在张家口市第一医院眼科行社区筛查的可疑房角关闭，合并轻度的白内障的128例（128只眼）患者，行早期的自内障超声乳化吸除联合囊袋内折叠人工晶状体植入术。结果128只眼的术后裸眼视力均有不同程度的提高（100％，128／128），术前、术后裸眼视力差异有统计学意义（P〈0．05），中央前房深度由术前的（1．79±0．46）mm，增加到术后的（2141±0．37）mm。两者差异有统计学意义（P〈0．05）。房角检查术后均较术前增宽。术后眼压均在（10-21mmHg）之间，术中及术后均未发生后囊破裂，角膜水肿等并发症。随访3年，无一例发生青光眼。结论对于可疑房角关闭合并轻度白内障的患者，行早期白内障超声乳化吸除术对防治青光眼的发生，改善视功能有重要的意义，而且手术并发症少，手术简单，值得推广。

Objective To investigate the feasibility, safety, efficacy and patient operation income ratio of early cataract phacoemulsification on primary angle-closure suspect. Methods The community screening of suspicious for primary angle closure, and mild cataract 128 cases （128 eyes） patients, phacoemulsification and early gettering joint capsular bag foldable intraocular lens implantation were performed. Results The different degrees of uncorrected visual acuity of 128 eyes after operation were improved （100%）, the difference was statistically significant uncorrected visual acuity before operation, after operation （P 〈0.05）, central anterior chamber depth by preoperative （1.79±0.46） ram, added to the postoperative （2.41±0.37） ram. The difference was statistically significant difference （P 〈0.05）. Chamber angle examination after operation was compared with the preoperative broadening. Postoperative lOP in （0-21mmhg）, intraoperative and postoperative were posterior capsular rupture, complications such as corneal edema. After 3 years of follow-up, no case of glaucoma occurred. Conclusions Suspicious for primary angle closure and mild cataract patients perform early cataract phacoemulsification can prevent and treat glaucoma, it has important significance of visual function improvement, and fewer complications. Surgery is simple and it is worthy to spread.