三联术治疗原发性闭角型青光眼合并白内障

Combining trabeculectomy/ECCE/IOL/implantation for primary angleclosure glaucoma with cataract

目的:本研究观察原发性闭角型青光眼(PACG)合并白内障时(G+C),施行小梁切除、白内障囊外摘出(ECCE)及后房型人工晶体植入(PC-IOL)联合手术的效果。方法:对30例(30眼)G十C患者施行小梁切除、ECCE及PC-IOL(三联)手术,术后平均随访23个月(6～48个月),分别对视力、眼压、前房及结膜滤过泡等观察检查。结果:视力,术前≤0.02 27眼(90%),术后0.2～1.0 25眼(83%)。眼压,术前平均5.37±1.80kPa,术后随访时平均2.51±0.40kPa,P<0.001。结膜滤过泡Ⅱ型24眼(80%),周边前房深度较术前增加,术后早期有虹膜炎反应及轻度角膜水肿。结论:G+C时,施行"三联"手术能取得良好效果,强调手术适应证选择与术后反应的处理。

Purpose. To investigate the effects of combining trabeculectomy/ECCE/PC -IOL implantation in the patients with coexisting PACG and cataract. Methods: combined surgery of trabeculectomy/ ECGE/PC-IOL implantation was peformed in 30 eyes(30 cases) of coexisting PACG and cataract. The patients were followed up postoperatively for mean 23 months (6 -48 months).The visual acuity,intraocular pressure (IOP), anterior chamber and filtering bleb were evaluated. Results: preoperative visual acuity:≤0.02 in 27 eyes (90%), postoperative visual acuity: ranged from 0.2 to 1.0 in 25 eyes(83%). The mean preoperative IOP. 5.37±1.80 kPa. The mean postoperative IOP. 2.51± 0.40kPa(P&lt;0.001). The filtering blebs of type Ⅱ presented in 24 eyes(80%). The depth of peripheral anterior Chamber (PACD) increased postoperatively. There were reactions of iritis and mild corneal edema at the early stage postoperatively. Conclusions. The results show that combined surgical therapy of trabeculectomy, ECCE and PC-IOL implantation can be obtained good effects to the patients of coexisting PACG and cataract. It must be emphasized to select the surgical indication and to manage postoperative reaction.