超声乳化白内障吸除联合小梁切除术治疗闭角型青光眼合并白内障

目的：探讨双切口白内障超声乳化吸除人工晶状体植入联合小梁切除术治疗闭角型青光眼合并白内障的临床疗效。方法：回顾分析双切口白内障超声乳化吸除人工晶状体植入联合小梁切除术治疗闭角型青光眼合并白内障患者65例70眼,术后随访3~12mo,观察视力、眼压及并发症的发生。
　　结果：术后患者视力≤0.1者2眼,>0.1~0.3者6眼,0.4~0.8者60眼,≥1.0者2眼,术后眼压在正常范围内(<21mmHg)者69眼,1眼术后出现浅前房,经治疗改善。
　　结论：双切口白内障超声乳化吸除人工晶状体植入联合小梁切除术治疗闭角型青光眼合并白内障手术成功率高,疗效佳,是一种理想的手术方式。     

超声乳化人工晶状体植入联合小梁切除术疗效观察

目的评价闭角型青光眼合并白内障行晶状体超声乳化人工晶状体植入联合小梁切除术的疗效。方法对36例(48眼)青光眼合并白内障施行晶状体超声乳化人工晶状体植入联合隧道内小梁切除术,观察术后视力、眼压、房角、眼底改变及视野变化。随访时间为术后1~6月。结果术后视力、房角均较术前改善,视野检查未发现进一步损害。术后眼压全部降至正常范围,平均眼压(16.02±2.14)mmHg。术后有一过性浅前房23眼。结论白内障晶状体超声乳化人工晶状体植入联合小梁切除术是治疗闭角型青光眼合并白内障的有效方法。     

晶状体超声乳化吸出联合小梁切除术对青光眼伴有白内障的疗效

目的探讨晶状体超声乳化吸出人工晶状体植入联合小梁切除术对青光眼伴白内障的疗效。方法开角型青光眼及慢性闭角型青光眼合并白内障共35例（52眼）。行晶状体超声乳化吸出人工晶状体植入联合小梁切除术,比较分析手术前后的视力、眼压控制及术后滤泡形成情况。结果术后矫正视力≥0．3者41眼（78．85％）,比术前视力≥0．3者（3眼,5．77％）明显增多。术后随访至少6个月平均眼压（14．71±4．01）mmHg,无需使用降眼压药物。术后功能型滤过泡47眼（90．38％）。无严重并发症发生。结论晶状体超声乳化吸出人工晶状体植入联合小梁切除术是一种安全、有效、便捷的治疗青光眼合并白内障的联合手术。     

晶状体超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术治疗青光眼合并白内障

目的 探讨晶状体超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术治疗青光眼合并白内障的效果及安全性.方法 对青光眼合并白内障52例(52眼)患者行超声乳化吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术,术后随访3个月,观察眼压、视力、滤过泡及并发症情况.结果 术后3个月,平均眼压为(14.38±4.37)mmHg(1kPa=7.5mmHg),较术前平均下降10.75mmHg;矫正视力≥0.5者28眼;功能性滤过泡41眼,非功能性滤过泡11眼.术中2眼后囊膜破裂,术后早期11眼角膜水肿、5眼浅前房,术后晚期4眼发生后发性白内障.结论 超声乳化白内障吸出人工晶状体植入联合隧道巩膜瓣下小梁切除术安全有效,视力恢复快,降压效果好,适用于青光眼合并白内障.     

闭角型青光眼合并白内障联合手术的疗效观察

目的了解超声乳化白内障吸除人工晶状体植入联合小梁切除术治疗原发性闭角型青光眼合并白内障的疗效。方法选取原发性闭角型青光眼合并白内障患者40例行超声乳化白内障吸除人工晶状体植入联合小梁切除术,记录术后三个月患者的视力、眼压、滤过泡。采用配对t检验,与术前眼压进行比较。结果术后三个月视力0.1-0.3共8只眼,0.4～0.5共22只眼,0.6～1.0共10只眼;眼压在8.7～20.3mmHg范围,平均15.5 mmHg,同术前比较,眼压下降有统计学意义(P<0.05)。未发生严重术中及术后并发症。结论联合手术是有效的安全的治疗青光眼合并白内障的方法。     

超声乳化人工晶状体植入联合小梁切除术

目的评价白内障超声乳化吸出、人工晶状体植入联合隧道内小梁切除术(三联手术)治疗青光眼合并白内障的疗效.方法对26例(28眼)青光眼合并白内障施行超声乳化及人工晶状体植入联合隧道内小梁切除.结果术后末次随访,矫正视力为0.05～1.0,其中＜0.1者2眼(7.14%),0.1～0.5者17眼(60.71%),＞0.5者9眼(32.14%).术后眼压全部降至正常范围,平均眼压(14.93±3.80)mmHg.术后根据Kronfeld分类,Ⅰ、Ⅱ型功能滤过泡24眼(85.71%).术后有角膜水肿5眼(17.86%),浅前房3眼(10.71%).结论白内障超声乳化人工晶状体植入联合隧道内小梁切除术是治疗青光眼合并白内障的良好方法.     

超声乳化人工晶状体植入联合小梁切除应用研究

目的：研究应用超声乳化人工晶状体植入联合小梁切除术的方法，并观察其效果。方法：对34例（47眼）白内障合并青光眼施行超声乳化人工晶状体植入联合小梁切除术，术后随访6－36月。结果：术后眼压均维持在正常范围，11－15mmHg(1mmHg=0.133kPa)者19眼，16－21mmHg者28眼。术后视力提高迅速且较稳定，除4眼青少眼性视神经萎缩者视力为0．1－0．2外，其余43眼视力为0．5－12。且无严重并发症出现。结论：超声乳化人工晶状体植入联合小梁切除术安全有效，便于临床推广应用。     

改良超声乳化联合小梁切除术的临床应用

目的探讨改良超声乳化联合小梁切除术治疗青光眼合并白内障的可行性及临床效果。方法对21例(21眼)青光眼合并白内障患者施行改良白内障超声乳化联合巩膜隧道切口内的小梁切除术,术后随访观察视力、眼压、滤过泡、人工晶状体位置等情况。结果术后平均随访1年,18眼术后视力均有不同程度提高。指数者2眼,<0.1者1眼,0.1～0.3者5眼,0.3以上者13眼,术后眼压均在正常范围,平均眼压为(12.32±4.06)mmHg(1mmHg=0.133kPa)。结论改良白内障超声乳化及人工晶状体植入联合巩膜隧道内小梁切除术,可达到降眼压和提高视力的双重效果,是青光眼合并白内障较好的手术方法之一。     

巩膜瓣下隧道式小切口青光眼白内障联合手术的临床研究

目的 探讨巩膜瓣下隧道式小切口白内障囊外摘出人工晶状体囊袋内植入联合小梁切除术治疗青光眼合并白内障临床疗效.方法 对56例青光眼合并白内障患者行巩膜瓣下隧道切口白内障囊外摘出人工晶状体植入联合小梁切除术,观察术后视力、眼压及并发症.结果 术后1周眼压平均(14.60±5.30)mmHg.与术前(27.60±5.80)mmHg相比,差异有统计学意义(t=8.86,P＜0.05).术后视力明显提高,无严重并发症.结论 巩膜瓣下隧道式小切口青光眼白内障联合手术是治疗青光眼合并白内障患者安全有效经济的手术方式.     

白内障超声乳化摘出人工晶状体植入联合小梁切除术

目的　评价青光眼合并白内障超声乳化摘出联合人工晶状体植入及小梁切除术的临床疗效。方法　应用白内障超声乳化摘出联合人工晶状体植入及小梁切除术治疗26例(26眼)白内障合并青光眼患者术后随访2～16个月。结果　平均眼压由术前24.82 mmHg(1 mm Hg=0.133 kPa)降到术后16.52 mmHg其中88.46%患者眼压被控制在21 mmHg以下,术后裸眼或矫正视力>0.3者80.77%,功能性滤泡占61.54%。结论　此手术方式安全可行,能使大部分青光眼合并白内障患者眼压控制并获得较好视力     

Glaucoma triple procedure comprising trabeculotomy with a fornix-based scleral flap

A new triple surgery procedure was applied to 20 primary open-angle glaucomatous (POAG) eyes. This technique comprises trabeculotomy with narrow (2–3 mm) fornix-based scleral flap, combined with extracapsular cataract extraction (ECCE) and posterior chamber intraocular lens (PC-IOL) implantation. As to surgical results, at two years postsurgery 53% (9/17) of the eyes were controlled under 21 mm Hg without medication, 35% (6/17) with topical medication alone. Eighteen (90%) eyes showed improved visual acuity of two or more Snellen lines. No serious postoperative complications occurred. There was no significant difference in postoperative astigmatism as compared with ordinary ECCE and PC-IOL surgery. Trabeculotomy with fornix-based scleral flap offers the advantage of simple and safe surgery when combined with ECCE and PC-IOL implantation.Abbreviations POAG primary open-angle glaucomatous - ECCE extracapsular cataract extraction - PC-IOL posterior chamber intraocular lens - IOP intraocular pressure     

高眼压青光眼白内障三联手术的临床观察

目的:探讨高眼压状态下白内障青光眼联合术的临床疗效。方法:对18例18眼白内障青光眼患者在高眼压下行小切口非超声乳化白内障囊外摘出人工晶状体植入联合小梁切除术,术后观察视力,眼压及并发症情况。结果:术后眼压均比术前用降眼压药的情况下明显下降,11～22mmHg者17例,其中眼压26mmHg者1例。术后视力均较术前有不同程度的提高,术后并发症发生率及严重程度并不比小梁切除术或白内障囊外摘除人工晶状体植入术高。结论:在高眼压下行小切口非超声乳化白内障囊外摘出人工晶状体植入联合小梁切除术发生并发症的机会增多,但仍是一种安全、有效的治疗白内障合并青光眼的联合手术。     

Comparative study of postoperative complications in primary and secondary implantation of posterior chamber intraocular lens in cataract surgery for diabetic patients]

Postoperative complications of diabetic cataract cases with active stage diabetic retinopathy, which underwent simultaneous extracapsular lens extraction (ECCE) and posterior chamber intraocular lens (PC-IOL) implantation in 84 eyes, ECCE only in 38 eyes and secondary implantation of PC-IOL after ECCE in 23 eyes, were studied. In the eyes of the primary PC-IOL implantation group, fibrous response in 35 eyes (42%), posterior iris synechia in 10 eyes (12%), progression of diabetic retinopathy in 13 eyes (16%), after cataract in 11 eyes (13%), pupil capture in 4 eyes (5%) and decentration of lens optics in 3 eyes (4%) were appeared, while in the ECCE only group, fibrous response in 11 eyes (29%), posterior iris synechia in 4 eyes (11%), after cataract in 11 eyes (29%), progression of diabetic retinopathy in 6 eyes (16%) were observed. On the other hand, in the secondary PC-IOL implantation group, only fibrous response was appeared in 1 eye (4%), Although PC-IOL implantation has been so far considered contraindication in cases with cataract combined with active stage retinopathy, the present studies strongly suggest that secondary PC-IOL implantation would be good indication in these cases whose blood sugar was properly controlled and the retinopathy was burned out by panretinal photocoagulation soon after ECCE.     

Extracapsular cataract extraction and posterior chamber intraocular lens implantation in glaucomatous eyes

Two hundred ninety-six eyes of 250 patients undergoing extracapsular cataract extraction (ECCE) with or without the implantation of a posterior chamber intraocular lens (PC-IOL) were studied. Pre-existing glaucoma of varying severity was present in 139 eyes and no known ocular pathology other than cataract in 157 eyes. During the first eight weeks following surgery, intraocular pressure elevations greater than or equal to 15 mmHg above baseline were seen in 23% of glaucomatous eyes controlled before surgery with glaucoma medications, in 39% of glaucomatous eyes controlled before surgery with argon laser trabeculoplasty, and in only 3% of nonglaucomatous eyes. The implantation of a PC-IOL did not influence the incidence of postoperative intraocular pressure (IOP) elevations. Among glaucomatous eyes with severe preoperative visual field loss (split fixation or central island less than or equal to 10 degrees), 9.7% had worsening of visual field after surgery. Open angle glaucoma of unclear etiology developed in 1.4% of normal eyes following uncomplicated ECCE with PC-IOL implantation. Surgical techniques the authors have found useful in glaucomatous eyes undergoing ECCE with PC-IOL implantation are discussed.     

后房型人工晶状体植入对青光眼滤过泡及眼压的影响

目的：探讨后房型人工晶状体植入对青光眼滤过泡及眼压的影响。方法：对25例26眼曾作过青光眼滤过性手术的白内障经颞下方角膜缘切口行白内障囊外摘除（ECCE）联合后房型人工晶状体（PC－IOL）植入手术。平均随访24．6个月。结果：视力≥0．5的有12（46．1％）;滤过泡无明显改变16眼（63．8％）,减少7眼（26．9％）,增大3眼（11．5％）;用或不用眼药能控制眼压占24眼（92．2％）;用或不用眼药能控制眼压占24眼（92．2％）,平均眼压为15．97mmHg;视野无明显改变占20眼（76．9％。结论经颞下方有膜缘切口行ECCE及PC－IOL植 已存青光眼滤过泡眼获得良好的视功能和眼压的稳定是一安全有效的方法。     

青光眼小梁切除术后白内障行囊外摘出与超声乳化吸出术比较

目的 比较青光眼小梁切除术后白内障行囊外摘出术与超声乳化吸出术的临床效果。方法 随机将青光眼小梁切除术后白内障分为A组行白内障囊外摘出术并人工晶状体植入术39眼，B组行超声乳化吸出术并人工晶状体植入术33眼。于术后1周、1、3和6月随访检查矫正视力、眼压、屈光度、角膜地形图和并发症。结果 术后矫正视力B组明显优于A组(P＜0．01)。术后6个月B组眼压下降明显优于A组(P＜0．05)。术后角膜散光A组＞B组(P＜0.05)，滤过泡及并发症2组间无明显差异。结论 青光眼小梁切除术后白内障行超声乳化吸出术较囊外摘出术临床效果良好，超声乳化吸出术术后角膜散光小，视力恢复迅速且稳定，长期观察眼压控制好。     

Primary angle closure glaucoma: Extracapsular cataract extraction or filtering procedure?

Summary An extracapsular cataract extraction (ECCE) with posterior-chamber-IOL was performed in 21 eyes of 20 patients with primary angle closure glaucoma (PACG; 2 suspects, 5 acute PACG, 14 chronic PACG). The ECCE was performed to improve the IOP. In 14 cases the ECCE was done in lieu of a filtering procedure. After the ECCE the anterior chamber deepened. The mean IOP was reduced from 31 mmHg preoperative to 16mmHg postoperative. Only 5 eyes needed additional medication after the ECCE. The IOP was reduced even if extensive peripheral anterior synechiae were diagnosed or after failed filtering procedures. The only temporary complication was the IOP-peak in the immediate postoperative period. It is concluded that an ECCE with PC-IOL should be seriously considered as the procedure of choice in PACG instead of a filtering procedure (or instead of a combined procedure).Presented in part at the Meeting of the Netherlands Ophthalmological Society, March 1987.     

膨胀期白内障继发性青光眼的治疗

目的 探讨膨胀期白内障继发性青光眼的手术治疗方法。方法 选择老年性白内障膨胀期继发性青光眼的入院患者47例（49只眼）,对其中28例（30只眼）施行4类不同方式的手术：（1）虹膜周边切除联合囊外白内障摘除术（extracapsular extraction of cataract,ECCE）及人工晶状体植入术（intraocular lens,IOL)(ECCE IOL);（2）虹膜节段性切除联合ECCE IOL;（3）小梁切除联合ECCE IOL;（4）五联手术,即后巩膜环钻 睫状体剥离 抽取玻璃体囊腔积液 ECCE IOL。结果 矫正视力进步者28只眼,无进步者2只眼,均为视神经萎缩者。眼压正常者18只眼,12只眼需局部滴用降眼压药后方可控制眼压。结论 大多数膨胀期白内障继发性青光眼患者可通过虹膜切除或小梁切除联合ECCE IOL治愈。对发病时间长、用药后眼压未控制、晶状体膨胀合并无前房的青光眼患者施行五联手术,可取得满意效果。     

白内障超声乳化吸除与囊外摘除人工晶体植入术后前房角对比观察

目的：对比观察巩膜隧道切口白内障超声乳化吸除折叠式人工晶体植入术和常规白内障囊外摘除人工晶体植入术后前房角对比情况。方法：采用Ｇｏｌｄｍａｎｎ房角镜分别观察３６眼巩膜隧道切口白内障超声乳化吸除折叠式人工晶体植入术和常规白内障囊外摘除人工晶体植入术后切口的变化、周边虹膜改变、晶体袢固定等情况。结果：白内障超声乳化吸除折叠式人工晶体植入术组及常规白内障囊外摘除人工晶体植入术组术后切口后弹力层脱离分别为     

恶性青光眼18例综合治疗的临床分析

目的:探讨恶性青光眼综合治疗方法的治疗效果。方法:对12例14眼小梁切除术后的恶性青光眼,6例6眼白内障囊外摘除+人工晶状体植入术后的恶性青光眼进行药物及玻璃体腔水囊抽吸术治疗。结果:白内障囊外摘除+人工晶状体植入术后的4例4眼恶性青光眼患者在术中发现并及时行玻璃体腔水囊抽吸联合前房形成术;其余14例16眼先用药物治疗2d无效后,行玻璃体腔水囊抽吸术1～2次,其中1例1眼(小梁切除术后)在行2次玻璃体腔水囊抽吸术后未能控制眼压、恢复前房,经行白内障囊外摘除+人工晶状体植入+玻璃体水囊抽吸术,全部成功。眼压控制理想,前房正常,随访平均21mo期间未复发。结论:恶性青光眼治疗中,抽吸玻璃体腔水囊、解除睫状环阻滞、建立前房是成功的关键。