双切口联合手术治疗青光眼合并白内障临床疗效观察

目的观察分析双切口白内障超声乳化吸出人工晶状体植入联合小梁切除术治疗青光眼合并白内障的效果。方法选取我院2010年6月至12月青光眼合并白内障患者60例(60眼),均接受双切口白内障超声乳化吸出人工晶状体植入联合小梁切除术,观察术前、术后的视力、眼压及并发症情况。结果 60例患者术前视力<0.1者30眼,0.1～0.3者18眼,0.3～0.5者12眼;术后视力均有提高,其中<0.1者9眼,0.1～0.3者16眼,0.3～0.5者20眼,0.5及以上者15眼;术前、术后视力比较,差异有统计学意义(P<0.05)。术后眼压为(14.58±2.32)mmHg(1kPa=7.5mmHg),与术前(29.08±7.59)mmHg相比,差异有显著统计学意义(P<0.01)。3例患者术中对其进行周边虹膜切除时发生出血,术后5例患者出现少量前房积血,2例患者出现前房纤维素性渗出,3例患者出现角膜上皮轻度水肿。结论双切口超声乳化吸出人工晶状体植入联合小梁切除术治疗青光眼合并白内障可明显改善患者视力,有效控制眼压。

Clinical effect of double incision combined surgery for glaucoma and cataract

Objective To observe the clinical effect of double incision phacoemulsification,intraocular lens implantation and trabeculectomy for glaucoma and cataract.Methods Sixty patients(60 eyes) with glaucoma and cataract in our hospital from June to December 2010 were chosen and performed double incision cataract phacoemulsification,intraocular lens implantation and trabeculectomy,the preoperative and postoperative visual acuity,intraocular pressure and complications were observed.Results The preoperative visual acuity of 60 eyes was <0.1 in 30 eyes,from 0.1 to 0.3 in 18 eyes,from 0.3 to 0.5 in 12 eyes,the postoperative visual acuity all increased,which was <0.1 in 9 eyes,from 0.1 to 0.3 in 16 eyes,from 0.3 to 0.5 in 20 eyes,and more than 0.5 in 15 eyes,there was statistical difference(P<0.05).The postoperative intraocular pressure was(14.58±2.32)mmHg(1 kPa=7.5 mmHg),compared with pre-operation(29.08±7.59)mmHg,there was significant difference(P<0.01).There were 3 cases with hemorrhage when the periphery iris excision was carried,5 cases with few hemorrhage in anterior chamber,2 cases with cellulose exudation in anterior chamber,3 cases with slight corneal epithelial edema.Conclusion Double incision phacoemulsification,intraocular lens implantation and trabeculectomy for glaucoma and cataract can obviously improve the visual acuity and control the intraocular pressure.