白内障超声乳化房角分离术治疗急性闭角型青光眼合并白内障的临床研究

目的探讨白内障超声乳化摘除及折叠人工晶体植入术治疗闭角型青光眼合并白内障的临床效果。方法对已诊断为闭角型青光眼合并白内障的60例患者的72只眼施行白内障超声乳化摘除及折叠人工晶体植入术,对房角关闭区域用粘弹剂、辅助钩和灌注头进行钝性分离。对比手术前后视力、房角镜下房角变化,对视野及眼压进行追踪随访时间≤2年者60眼,〉2年者12眼。结果有1只眼再发眼压升高,施行小梁切除术后眼压控制,其余患者眼压控制正常范围,50眼术后房角开放,除再发眼压升高的1只眼的视野继续损害外,71只眼均无视野缩小。结论超声乳化白内障摘除联合房角分离术是治疗闭角型青光眼的有效方法。

Clinical Study of Phacoemulsification Combined with Goniosychialysis for the Treatment of Glaucoma with Cataract

Objective To study the clinical effect of phacoemulsification and goniosychialysis for the treatment of angle-closure glaucoma withcataract.Methods 60 eyes of 72 patients were undergone phacoemulsification and IOL implantation,combined withgoniosychialysis.The main outcome measures were pre-operation and post-operation change of anterior chamber angle,visual,visual field and intraocular pressure.60 eyes were followed up within 2 years,12 eyes over 2 years.Results The intraocular pressure of 1 eye raised again.After the management of trabeculectomy the pressure was controlled.The anterior chamber angles of 50 eyes were open.The visual fields of 71（71 or 72） eyes had no contraction except for 1 eye with raised intraocular pressure.Conclusion Phacoemulsification combined with goniosychialysis is an effective surgery for angle-closure glaucoma except for inflammative glaucoma.