青光眼小梁切除术后白内障超声乳化术的临床观察

Clinical research on phacoemulsification for complicated cataract after trabeculectomy

目的探讨闭角型青光眼术后白内障患者行白内障超声乳化吸除联合折叠人工晶状体植入术的临床效果。方法淮南市第一人民医院2012年6月至2015年6月收治30例（32只眼）青光眼小梁切除术后白内障患者,盐酸奥布卡因眼药水表面麻醉,经颞侧透明角膜行白内障超声乳化联合折叠人工晶状体植入术,术中记录超声乳化时间、超声乳化能量、流量及负压;术后1-18个月随访,观察患者视力、角膜散光度、角膜内皮计数、眼压、前房深度及其他术后并发症情况。结果大多数患者术后视力恢复满意,眼压控制平稳,前房角深度较术前显著加深,上方滤过泡未见明显改变。术后角膜水肿18只眼,前房炎性渗出5只眼,均在3-10 d内消退。后囊破裂及玻璃体溢出2只眼,无虹膜损伤病例。结论超声乳化术治疗青光眼小梁切除术后白内障具有较好的临床疗效,能有效控制眼压,提高视力,减少术后并发症。

Objective To observe the results of phacoemulsification and soft intraocular lens implantation in patients with complicated cataract angle-closure glaucoma surgery. To summarize the treatment options in order to provide the guidance for clinical management. Methods Thirty patients（ 32 eyes） with cataract after glaucoma surgery admitted to Huainan First People＇s Hospital from June 2012 to June 2015 were enrolled in this study. Tropical oxybuprocaine was used for surface anesthesia. Patients received phacoemulsification and IOL implantation through temporal incision. Visual acuity,astigmatism,intraocular pressure（ IOP）,corneal endothelial cells（ CECs）,anterior chamber angle and depth,and complications were assessed. Follow up was from 1 to 18 months. Results Most patients acquired satisfied visual acuity.Postoperative IOP was stable and anterior chamber angle was deepened after the operation. Filtering blebs were intact.Complications included corneal edema（ n = 18） and mild inflammation in anterior chamber（ n = 5） at day 1. All symptoms waned within 3-10 days. Conclusions Cataract phacoemulsification and foldable IOL implantation had good clinical results for patients who received trabeculectomy recently. The surgery can reduce IOP,improve visual acuity and reduce the complications.