小切口小梁切除联合超声乳化白内障吸除术治疗青光眼合并白内障

目的　探讨 3 5mm小切口小梁切除联合超声乳化白内障吸除后房型人工晶状体植入术 (三联手术 )治疗青光眼合并白内障患者的效果。方法　应用小切口三联手术对 2 0例 (2 6只眼 )青光眼合并白内障患者进行手术治疗。术后随访 3～ 41个月 ,平均 16 1个月。结果　术前平均眼压(2 3 0 1± 2 6 3)mmHg(1mmHg =0 133kPa) ,术后随访最终平均眼压降至 (13 93± 1 85 )mmHg(P <0 0 0 1)。术后随访最终矫正视力范围 0 0 5～ 1 0 ,其中≥ 0 6者 17只眼 (6 5 % ) ,术后平均散光度0 81D ,其中 4只眼无散光度。术后早期 2只眼使用降眼压药物 ,随访后期无使用者。术后早期并发症角膜水肿 5只眼 (19% ) ,浅前房 3只眼 (12 % ) ;晚期并发症后发性白内障 6只眼 (2 3% )。结论　小切口三联手术治疗青光眼合并白内障患者 ,具有恢复有用视力、稳定眼压、减少术后用药、并发症少等理想效果。

Trabeculectomy combined with phacoemulsification for treatment of glaucoma complicated with cataract

OBJECTIVE: To evaluate the effectiveness of small-incision triple procedure, including phacoemulsification, posterior chamber intraocular lens implantation and trabeculectomy, in patients with coexisting glaucoma and cataract. METHODS: Twenty patients (26 eyes) with coexisting glaucoma and cataract underwent 3.5 mm-incision triple procedure. The mean follow-up was 16.1 months (3 - 41 months). RESULTS: The mean preoperative intraocular pressure (IOP) was (23.01 +/- 2.63) mm Hg (1 mm Hg = 0.133 kPa) which decreased to a mean postoperative IOP of (13.93 +/- 1.85) mm Hg (P < 0. 001). Seventeen (65%) of 26 eyes had a best-corrected visual acuity of >or= 0.6 at the last follow-up (range, 0.05 - 1.0). The mean magnitude of astigmatism was 0.81 D (range, 0 - 3.00 D), 4 eyes had no astigmatism. Although 2 eyes used antiglaucoma medications shortly after the surgery, no eyes used any medications at the last follow-up. The early postoperative complications included corneal edema in 5 eyes (19%) and shallow anterior chamber in 3 eyes (12%). The late complication was mainly the after cataract in 6 eyes (23%). CONCLUSIONS: The small-incision triple procedure appears effective for treating selected patients with coexisting cataract and glaucoma, improving the valid visual acuity rapidly, reducing intraocular pressure with less medications and having less postoperative complications.