青光眼伴晶状体异位联合手术的效果观察

Observation on the efficacy of combined glaucoma and cataract surgery for angle-closure glaucoma with ectopia lentis

目的：观察伴晶状体异位的急性原发性闭角型青光眼（ PACG）进行青光眼白内障联合手术的效果。方法回顾性分析2014年1月至2016年1月本院伴晶状体异位的急性PACG 27例（31眼）。控制眼压后行超声乳化人工晶状体植入与小梁切除联合手术。术后随访6个月,观察视力、眼压及视野等。结果术前急性发作时眼压〉60 mmHg（1 mm Hg=0.133 kPa）者22例（22眼）；术中植入张力环者7例（7眼）,行前段玻璃体切除术者6例（6眼）,睫状沟缝合固定IOL者1例（1眼）；术后6个月视力较术前显著提高（Z=-4.783, P=0.000）。术后1周、4周、3个月、6个月眼压较术前明显降低（t=20.929,20.475,19.213,19.747；P=0.000）。术后6个月视野稳定。结论对于伴晶状体异位的PACG急性发作患者行青光眼白内障联合手术能够有效控制眼压、提高视力并稳定视野。

Objective To observe the efficacy of glaucoma and cataract combined surgery for the treatment of acute primary angle-closure glaucoma with ectopia lentis. Methods The data of 31 eyes of 27 patients of acute primary angle-closure glaucoma with ectopia lentis treated in our hospital from January 2014 to January 2016 were analyzed retrospectively. After the combined surgery of glaucoma and cataract, the intraocular pressure, vision acuity and vision field were observed. The follow up time was 6 months. Results The preoperative IOP of acute onset over 60mmHg （1mmHg=0. 133 kPa） were in 22 eyes of 22 cases. Tension rings were implanted in 7 eyes of 7 cases. The previous section vitrectomy were done in 6 cases. Sutured posterior chamber intraocular lens in 1 case. Postoperative 6 months, visual acuity improved significantly （Z= -4. 783,P =0. 000）. At 1 week, 4 weeks, 3 months and 6 months after operation compared with before operation IOP were significantly lower （ t =20. 929,20. 475,19. 213,19. 747; P =0. 000）. The vision field was stable 6 months after surgery. Conclusion The combined surgery of glaucoma and cataract could effectively control IOP, improve visual acuity and stabilize vision field.