超声乳化白内障摘除联合IZHV术治疗恶性青光眼疗效观察

Efficacy of ultrasound phacoemulsification cataract extraction in combination with IZHV on malignant glaucoma

目的观察超声乳化白内障摘除+人工晶体植入+经角膜切口虹膜周切-部分悬韧带切除-玻璃体前界膜切开-前部玻璃体切除术(IZHV)治疗恶性青光眼的疗效,探讨其安全性。方法2022年8月—2023年8月河南省人民医院诊治恶性青光眼患者10例(10眼),常规行超声乳化白内障摘除+人工晶体植入术后,经角膜切口行IZHV。术后1周测量患者裸眼视力、眼压、前房深度,评估疗效,记录人工晶体移位、脉络膜脱离、眼压升高和浅前房等并发症发生情况。结果术后1周,10例视力提高(6例视力≥0.3,4例<0.3),眼压(8.2~16.5 mmHg)、前房均恢复正常,均达到痊愈,均未发生人工晶体移位、脉络膜脱离、眼压升高和浅前房等并发症。结论恶性青光眼患者行超声乳化白内障摘除+人工晶体植入+经角膜IZHV术安全、有效。

Objective To evaluate the efficacy and safety of ultrasound phacoemulsification cataract extraction+intraocular lens implantation+irido-zonulo-hyaloid-vitrectomy(IZHV)procedure via corneal incisional approach in treating malignant glaucoma.Methods Ten patients(10 eyes)were diagnosed with malignant glaucoma in Henan Provincial People's Hospital from August 2022 to August 2023.After routine ultrasound phacoemulsification cataract extraction and intraocular lens implantation,IZHV was performed via corneal incisional approach.One week after surgery,the naked visual acuity,intraocular pressure,and anterior chamber depth were measured for efficacy evaluation.The occurrences of complications such as intraocular lens displacement,choroidal detachment,intraocular pressure elevation and shallow anterior chamber were recorded.Results One week after surgery,the visual acuity was improved in 10 patients(≥0.3 in 6 patients and<0.3 in 4).The intraocular pressure ranged from 8.2 to 16.5 mmHg,and the anterior chamber returned to normal.All patients achieved recovery without complications such as intraocular lens displacement,choroidal detachment,intraocular pressure elevation,or shallow anterior chamber.Conclusion The surgery of ultrasound phacoemulsification cataract extraction+intraocular lens implantation+IZHV via corneal incisional approach is safe and effective for patients with malignant glaucoma.