小切口白内障摘除联合房角分离术治疗闭角型青光眼合并白内障疗效分析

目的探讨小切口白内障摘除联合房角分离术治疗闭角型青光眼合并白内障的临床疗效。方法闭角型青光眼合并白内障56例(56眼),术前房角开放超过180°,均行小切口白内障摘除人工晶体植入联合房角分离术,术后随访8～12个月。观察手术前后视力、眼压、房角的变化。结果术前平均眼压(19.45±5.01)mmHg,术后平均眼压(10.11±2.94)mmHg,差异有统计学意义(P<0.05)。术前周边前房深度<1/2CT者36例,术后周边前房深度≥1CT者43例,所有眼术后房角加宽,大部分开放,术前视力≤0.05者18眼,占32.14%,术后视力≥0.3者35眼,占62.5%,患者满意度较高。结论房角开放超过180°的闭角型青光眼合并白内障患者单纯行小切口白内障摘除联合房角分离术可以较好地控制眼压,并提高视力。

Efficacy of micro-incisal opening extracapsular catarct extraction and angle of anterior chamber commissurotomy to cure angle-closure glaucoma with catarct

Objective To probe the clinical curative effect of micro-incisal opening extracapsular catarct extraction(ECCE) and angle of anterior chamber commissurotomy to cure angle-closure glaucoma with catarct.Methods There were 56 patients who had angle-closure glaucoma with catarct.All the patients whose angle of anterior chamber opened over 180°,they all had micro-incisal opening ECCE+IOL+ angle of anterior chamber commissurotomy,and been followed up 8~12 months.Observed the change of vision,intraocular pressure and angle of anterior chamber perioperatively.Results Preoperative,the average intraocular pressure was(19.45±5.01)mmHg.Postoperative,the average intraocular pressure was(10.11±2.94)mmHg.The difference had statistical significance(P<0.05).There were 36 patients whose peripheral chamber depth was less than 1/2CT preoperative.There were 43 patients whose peripheral chamber depth was larger or equal to 1CT postoperative,and all eyes peripheral chamber depth widened.There were 18 eyes that sight was less than 0.05,occupied 32.14% before the operation,there were 35 eyes that sight was higher than 0.3,occupied 62.5%.Conclusion The patient who has angle-closure glaucoma with catarct,and the angle of anterior chamber opened over 180° do the operation of micro-incisal opening ECCE and angle of anterior chamber commissurotomy,it can control the intraocular pressure betterly,and raise vision.