弹性切口手法碎核人工晶体植入,联合隧道内小梁切除术——弹性切口手法碎核人工晶体植入联合隧道内小梁切除术的疗效探讨

Extracapsular cataract extraction by manual nuclearfragment and intraocular lens implantation combined with trabeculectomy through stretch incision

目的:探讨弹性切口手法碎核人工晶体植入联合隧道内小梁切除术治疗青光眼合并白内障的效果。方法:对22例(22只眼)青光眼合并白内障患者行弹性切口手法碎核白内障摘除及后房型人工晶状体植入后,再行隧道内小梁切除。术后观察视力、眼压、滤过泡及并发症。结果:随访平均6个月,术前视力<0.1者19只眼,0.1～0.2视力3只眼,术后视力<0.1者4只眼,术后视力>0.2者18只眼,术后眼压控制好,22只眼眼压<20mmHg,功能滤过泡20只眼。术后并发症主要是角膜水肿及虹膜炎症,渗出膜形成。结论:弹性切口手法碎核白内障摘除人工晶体植入联合隧道内小梁是目前治疗青光眼合并白内障的一种好方法,安全,有效方便,价廉,适合基层医院开展。

Objective:To investigate the effect of trabeculectomy combined with extracapsular cataract extraction by manual nuclearfragment and intraocular lens implantation through stretch incision in treatment of glaucoma with cataract. Methods:Through stretch incision,IOL by manual nuclearfragment combined with trabeculectomy was performed on 22 cases (22 eyes) suffered from glaucoma with cataract. Visual acuity,IOP,filtration bleb and complication were observed after operation. Results:The average follow- up period was 6 months. Preoperatively,there were 19 eyes with visual acuity lower than 0.1 and three eyes with visual acuity range from 0.1 to 0.2. Postoperatively,there were 4 eyes with visual acuity lower than 0.1 and 18 eyes better0.2. IOP was well controlled after operation and lower than 20mmHg in 22 eyes. Functional filtration bleb was formed in 20 eyes. Corneal edema and iritis with exudation membrane formation were the main postoperative complications. Conclusions:IOL by manual nuclearfragment combined with trabeculectomy through stretch incision is a good means to treat glaucoma with cataract. It’s safe,effective, convenient and inexpensive so that it’s suitable in basic level hospital.