人工晶状体植入治疗急性原发性闭角型青光眼

目的 探讨白内障超声乳化联合人工晶状体植入术治疗瞳孔阻滞缓解后伴白内障急性原发性闭角型青光眼的疗效.方法 对43例(47眼)伴白内障闭角型青光眼患者经药物治疗缓解瞳孔阻滞后,行白内障超声乳化术和人工晶状体植入术.观察手术前后眼压、视力、前房角及中央前房深度的变化.结果 术后随访6～12个月,平均眼压由术前的(18.5±5.5)mm Hg(1 mm Hg=0.133 kPa)降至(13.5±4.5)mm Hg,差异有统计学意义(P<0.05);视力均有不同程度提高,差异有统计学意义(P<0.05);前房角均较术前增宽,可见大部分睫状体带;平均中央前房深度由术前的(3.25±0.35)mm降至(1.30±0.25)mm,差异有统计学意义(P<0.01).结论 白内障超声乳化联合人工晶状体植入术治疗瞳孔阻滞缓解后的急性原发性闭角型青光眼伴白内障有效.

Treatment of acute primary angle-closure glaucoma with phacoemulsification and intraocular lens implantation

Objective To investigate the therapeutic effect of phacoemusification and intraocular lens（IOL） implantation on acute primary angle-closure glaucoma （APACG） combined with cataract after the relief of pupillary block. Methods Phacoemusification and IOL implantation was performed in 47 eyes of 43 patients with APACG who had cataract after the relief of pupillary block by medicine. The preoperative and postoperative intraocular pressure（ IOP）, visual acuity, anterior chamber angle and the mean central anterior chamber depth was observed respectively. Results The patients were followed up for 6 to 12 months. The mean lOP significantly decreased from （18.5 ±5.5 ） mm Hg（ 1 mm Hg = 0. 133 kPa） to （ 13.5± 4.5） mm Hg postoperatively （ P 〈 0.05 ）. The postoperative visual acuity became better in different degrees in all eyes（P 〈0.05 ）. The anterior chamber angles were wider and the ciliary belts were easily observed after the operation. The mean central anterior chamber depth significantly decreased from （ 3.25 ± 0.35 ） mm to （ 1.30 ± 0.25 ） mm（ P 〈 0.01 ）. Conclusions Phaeoemulsification and IOL implantation was a useful method for the treatment of angle closure glaucoma with cataract after the relief of papillary block.