抗青光眼滤过术后白内障超声乳化后房型折叠式人工晶状体植入

Phacoemulsification with the implantation of posterior chamber foldable intraocular lens in glaucomatous eyes after filtering surgery

目的 :评价青光眼滤过术后白内障超声乳化后房型折叠式人工晶状体植入的疗效。 方法 :对抗青光眼小梁切除术后白内障患者 43例 (5 0只眼 ) ,采用 3.2mm透明角膜隧道切口进行超声乳化白内障吸除联合折叠式人工晶状体植入 ,随访 3～ 2 4个月 ,观察术后视力、角膜散光、角膜地形图及眼压情况。 结果 :白内障术后患者视力均有不同程度提高 ,术后 3个月视力≥ 0 .5者占 72 .0 % ;术前角膜散光 (1.31± 0 .92 )D ,术后 3个月角膜散光 (1.2 5± 0 .87)D ,与术前比无显著差异 (P >0 .0 5 ) ;角膜地形图显示已恢复术前状态 ;术前眼压为 (2 .18± 0 .32 )kPa ,术后 1个月眼压为 (2 .2 3± 0 .2 8)kPa ,与术前比无显著差异 (P >0 .0 5 )。 结论 :对抗青光眼滤过术后白内障患者行透明角膜隧道切口白内障超声乳化折叠式人工晶状体植入术可提高患者视力 ,同时保持滤过泡功能 ,角膜散光无明显改变且不影响眼压的控制 。

Objectives:To evaluate the curative effect of phacoemulsification with the implantation of posterior chamber foldable intraocular lens in glaucomatous eyes after filitering surgery. Methods:Fifty filtered glaucoma eyes with cataract were operated with phacoemulsification and implantation of foldable intraocular lens through a 3.2 mm clear corneal tunnel incision.During the postoperative 3～24 months follow-up period, visual acuity,corneal astigmatism, corneal topography and intraocular pressure(IOP) were observed . Results:The postoperative visual acuity of all patients improved in different degrees, with ≥0.5 in 72.0% in the third month. Postoperative astigmatism in the third month were (1.25± 0.87)D,compared with preoperative(1.31±0.92)D,there was no significant difference(P>0.05),and corneal topography had recovered.Postoperative IOP at 1 month was ( 2.18±0.32)kPa,there was no significant difference compared with preoperative (2.23±0.28)kPa(P>0.05). Conclusions:Glaucomatous eyes with cataract after filtering operation can rehabilitate their visual acuity and maintain the functional filtering bleb by phacoemulsification with foldable intraocular lens implantation through a clear corneal tunnel incision.Patient's corneal astigmatism change little,and the IOP control is not affected.The operation is safe and reliable.