小切口白内障手术治疗白内障合并青光眼临床疗效观察

目的：比较观察小切口白内障摘除联合后房型人工晶体植入术治疗白内障合并不同房角关闭程度的闭角型青光眼患者的临床疗效。方法：41例（43眼）白内障合并闭角型青光眼患者,根据房角关闭程度分为A、B两组：A组（房角关闭粘连≤180°）25眼,B组（房角关闭粘连〉180°）18眼。均施行小切口白内障摘除联合人工晶体植入手术。观察二组手术前后视力、眼压、前房深度、房角变化情况并进行统计分析处理。结果：41例（43眼）白内障合并闭角型青光眼患者术后视力均有提高,房角加深。房角镜检查：A组25眼房角完全开放12眼,房角关闭粘连≤90°者8眼（80%）,房角关闭粘连90°～180°者5眼。B组（房角关闭粘连（180°）18眼中房角关闭粘连≤90°者4眼,房角关闭粘连（180°14眼（78%）。A组优于B组,二者差异有统计学意义（P〈0.05）。眼压：术前A组（44.36±4.27）mmHg,B组（47.01±4.35）。术后一周：A组眼压控制在（15.96±3.97）mmHg,B组眼压控制在（16.20±5.56）mmHg;B组术后6月：6眼需加用降眼压药物,5眼青光眼发作行抗青光眼滤过手术。A组优于B组,二者差异有统计学意义（P〈0.05）。结论：白内障合并闭角型青光眼患者,单纯小切口白内障摘除联合人工晶体植入手术,可有效治疗房角关闭粘连≤180°患者。而对于房角关闭粘连〉180°患者,单纯小切口白内障摘除联合人工晶体植入手术效果不佳,可考虑行青白联合手术,或需降眼压药物治疗。

Clinical Analysis the Combined Trabeculectomy With Adjustable Suture for Angle-closure Glaucoma

Objective:To research the effect of the combined trabeculectomy with adjustable suture for angle-closure glaucoma.Methods:55 cases with primary glaucoma were underwent the combined trabeculectomy.The adjustable suture method of scleral flap was adopted during operation.Observing the intraocular pressure,the anterior chamber,the filter-bubble and the loose of adjustable suture,etc.after operation.Results:All cases were followed up for 6~12 months,average 8.7 months.The adjustable suture was pulled out for 3~...