白内障超声乳化联合房角分离手术治疗闭角型青光眼合并白内障

目的 探讨超声乳化联合房角分离术治疗闭角型青光眼合并白内障的临床效果.方法 闭角型青光眼合并白内障60例(64眼)；男38例(40眼),女22例(24眼)；急性闭角型36例,慢性闭角型24例.年龄60～80岁,平均73岁.全体患者均接受超声乳化人工晶状体植入联合房角分离术.对手术前、后的眼压、视力、周边前房深度及房角的变化进行了6～12个月随访观察.结果 术前平均眼压(18.38±4.38) mm Hg,术后(10.73±3.10) mm Hg,手术前后眼压比较t值为4.67(P ＜0.05),差异有统计学意义.术前BCVA≤0.05者15眼,占23.44％,术后BCVA≥0.3者51眼,占79.69％.术前周边前房深度＜1/2 CT者46眼,术后周边前房深度≥1 CT者36眼；术后前房角可见不同程度开放.术中及术后无严重并发症发生.结论 超声乳化联合房角分离术治疗闭角型青光眼合并白内障可以有效地缓解病情.

Clinical study on the treatment of primary angle-closure glaucoma with cataract by phacoemulsification combined with goniosynechialysis

Objective To investgate the clinical effect of phacoemulsification combined with goniosynechialysis on primary angle-closure glaucoma with cataract.Methods It was a retrospective study.There were 60 cases (64eyes) diagnosed primary angle-closure glaucoma (PACG) with cataract in our hospital,from 2007 to 2010,Male38cases (40 eyes) and female 22 cases (24eyes).Their age were from 60 to 82 years old,mean age is 73.6 years old.36 cases with PACG,24 cases with CPAG were undergone phacoemulsification and IOL implantation,combined with goniosynechialysis.The intraocular pressure (IOP) before and after operation、best corrected visual acuity (BCVA)、peripheral anterior chamber (PAC)and the change of anterior chamber angle were all observed and reported.The time of following-up was 6 to 12 months.Results Preoperative IOP were from 13.18 to 30 mmHg and mean IOP is (18.38+ 4.38)mmHg.Mean-while the postoperative IOP were (10.73+ 3.10)mmHg.The IOP were obviously decreased after operation.There were 15eyes (23.44□)whose preoperative BCVA mere less than 0.05.There were 51eyes(79.691)whose postoperative BCVA were more than 0.3.There were 46 eyes whose preoperative PAC depth were less then 1/2 CT.There were 36eyes whose postoperative PAC depth were more than one CT.The angle-closure can be partly opened.Conclusion The threatwent of primary angle-closure glaucoma with cataract by phacoemulsiflcation combined with goniosynechialysis is safe and effective.