闭角型青光眼术后高眼压合并白内障患者人工晶状体植入术的疗效观察

Effect of intraocular lens implantation on the postoperative high intraocular pressure with cataract in angle closure glaucoma

目的 :探讨闭角型青光眼术后高眼压患者施行白内障超声乳化及人工晶状体植入术对眼压的影响 ,了解视野变化及视力恢复情况。方法 :对 32例 41只眼闭角型青光眼术后高眼压合并白内障的患者行白内障超声乳化及人工晶状体植入术。术后随访 ,测量眼压 ,观察视野及房角并检查视力 ,所得数据与术前进行比较并对有关数据进行统计学处理。结果 :38只眼术后眼压正常 ,均 <2 1mmHg。 2只眼眼压在 2 2～ 30mmHg之间 ,较术前 (34只眼 )明显降低 ,差异有显著性 (P <0 0 0 1 ) ,眼压 >30mmHg者仅 1只眼 ,和术前 (7只眼 )对照明显减少 ,差异有显著性 (P =0 0 2 6) ;观察视野 6～ 1 8个月 ,视野进行性缩小2只眼 ,与术前比较 (9只眼 )明显减少 ,有显著差异 (P =0 0 2 3)。房角关闭范围达 1 /2象限以上者从术前的 53 66 %下降到2 9 2 7%。视力均有不同程度提高。结论 :对于闭角型青光眼术后高眼压合并白内障的患者 ,通过施行白内障超声乳化及人工晶状体植入手术可以有效地降低眼压 ,防止视野进一步损害 。

Objective:To evaluate the effect of ultrasound emulsification and implantation of intraocular lens on the intraocular pressure,visual field and vision of the cataract patients who had high intraocular pressure after angle closure glaucoma operation.Methods:Ultrasound emulsification and implantation of intraocular lens were performed in 32 cataract patients(41 eyes)who had high intraocular pressure after angle closure glaucoma operation.After operation,the intraocular pressures,visual fields and visions were compared with the preoperative ones statistically.Results:Of the 41 eyes,the postoperative intraocular pressure in 38 eyes were normal (<21 mmHg),and the number of eyes with intraocular pressure between 22～30 mmHg decreased from preoperative 34 eyes to postoperative 2 eyes.This had significant diversity ( P <0 001).The number of eyes with intraocular pressure higher than 30 mmHg decreased from preoperative 7 eyes to postoperative 1 eye.This also had significant diversity( P =0 026).Visual fields of 41 eyes were observed 6～18 months postoperatively.The visual fields of 2 eyes reduced progressively,with significant diversity ( P =0 023)as compared with preoperative 9 eyes.Vision of all 41 eyes improved differently. Conclusion:The intraocular pressures in the patients with cataract and high intraocular pressure after operation for angle closure glaucoma were lowered effectively by ultrasound emulsification and implantation of intraocular lens,and the operation may protect the eyes from further loss of visual field and vision.