晶状体摘除联合人工晶状体植入术治疗急性闭角型青光眼

Study of cataract extraction combined with IOL implantation for acute angle-closure glaucoma

目的:探讨治疗伴有晶状体膨胀或不同程度白内障的急性闭角型青光眼的手术方式。方法:采用晶状体超声乳化+折叠型人工晶状体植入或小切口晶状体囊外摘除联合人工晶状体植入手术治疗25例27眼急性闭角型青光眼合并白内障患者,对其结果进行分析。结果:术前平均眼压:53.6mmHg,术后随访最终平均眼压降至(13±4.8)mmHg。术后随访最终矫正视力范围为4.0～5.0,其中4.7以上者16只眼(占59％)。术后早期2只眼使用降眼压药物,随访后期无使用。术后早期有并发症,角膜水肿9眼(33％),术后第2天丁达氏征(++)或(+++),人工晶状体表面形成纤维膜5只眼,经活动瞳孔、激素治疗5～7d缓解。结论:采用晶状体摘除联合人工晶状体植入术治疗急性闭角型青光眼,是一种有效、便捷、可重复、并发症少的治疗急性闭角型青光眼的手术方式。

Objective: The study was designed to determine the better methods for acute angle-closure glaucoma. Methods: The treament of acute angle-closure glaucoma on 25 cases(27 eyes) of in-patient were analysed. These patients were treated with phacoemulsification and F-IOL implantation or small incision cataract extraction and IOL implantation.Results:The mean intraocular pressure before operation was 53.6 mmHg. After operation the mean intraocular pressure was declined to 12.5 mmHg. The best postoperative corrected visual acuities were 4.0-5.0 among them. The early postoperative complication were: comeal edama 9 eyes heavy postoperative inflammato-ry reaction,tnydll() or () two days after operation, fibrous membranes above IOL: 5 eyes. These complications were alleviated through the movement of pupil and steriod eye drops 5 - 7 d. Conclusion: Cataract extraction combined with IOL implantation could control the intraocular pressure effectively. It was an effective, convenient, re-usable, safe and limited complication surgery.