小切口非超声乳化白内障青光眼联合手术的临床疗效观察

目的探讨小切口非超声乳化白内障摘除人工晶体植入联合小梁切除术治疗白内障合并青光眼的临床疗效。方法对36眼白内障合并青光眼的患者,行小切口非超声乳化白内障摘除人工晶体植入联合小梁切除术,术后观察术眼视力、眼压、滤过泡、并发症等情况,术后随访6个月～1年。结果术后6个月随访时,32眼（88.89%）术后视力有不同程度的提高,其中术后视力大于0.3者为26眼（72.2%）。术后眼压：术后1周,25眼（69.4%）眼压低于21mmHg;术后6个月,31眼（86.1%）眼压低于21mmHg,仅有3眼（8.3%）眼压高于24mmHg,给予2%卡替洛尔滴眼液治疗,眼压都能控制在正常范围,患者无不适症状。术后有33眼（91.6%）形成弥散扁平的功能性滤过泡,其中I型滤过泡21眼,II型滤过泡12眼。术后有角膜水肿7眼,浅前房4眼,术中术后未见严重的并发症。结论小切口非超声乳化白内障摘除人工晶体植入联合小梁切除术治疗白内障合并青光眼,不但能很好的控制眼压,迅速恢复视力,而且并发症少,该方法是一种安全、有效、经济实用的手术方法,值得临床应用。

Investigation of small incision non-phacoemulsification cataract extraction combined with trabeculectomy

Objective To investigate the effect of combined surgery of improved small incision introcular lens implantation and glaucoma.Combined surgery were performed on 36 eyes of cataract with glaucome,the postoperative visual acuity,interocular Methods pressure,filtering blet and complication were investigated after follow-up 6 months～1 year.Results 32eyes（88.9%） had improved visual acuity.26 eyes（72.2%）had the best corrcetd visual acuity 0.3.At 1 week after surgery,25eyes（69.4%）had the Iop 21mmHg.At 6 months after surgery,31 eyes（86.1%）had the Iop 21 mmHg,3 eyes（8.3%） Iop were above 24mmHg and could be controled in normal range by 2% carteolol.33eyes（91.6%）had the functional filtering blet,I type filtering blet in 21 eyes,II type filtering blet in 12 eyes.Cornea edema occurred in 7 eyes,shallow antrior chamber occurred in 4 eyes.No serious complications occurred in or after operation.Conclusion Combined surgery could control Iop effectively and restore acuity early with less complication.It is a safe effcetive and economic method and worth expanding.