微小巩膜隧道瓣的白内障超声乳化联合小梁切除术

目的:探讨微小巩膜隧道瓣白内障超声乳化联合小梁切除术的可行性。方法:对青光眼合并白内障49例52眼行2.8mm巩膜隧道瓣切口的白内障超声乳化联合巩膜隧道内的小梁切除术。结果:术后52眼眼压控制满意,术后1wk;1,3,6mo眼压平均值分别为:(8.24±3.61)mmHg,(13.22±4.12)mmHg,(12.11±4.23)mmHg,(12.59±4.26)mmHg。取本组术后半年平均眼压与行5.5mm巩膜隧道瓣白内障超声乳化、植入一片式硬性PMMA人工晶状体并联合小梁切除术的56眼术后半年平均眼压(13.27±3.84)mmHg进行对比分析无统计学意义(t=1.7536,P=0.08239)。26眼手术前后随访1a,视网膜神经纤维层厚度变化无统计学意义(P>0.05)。术后裸眼视力达到或超过0.8者占62%。结论:该术式切口小,无需做巩膜瓣,切口无需缝合,并避免滤过过畅,减少术后散光发生,迅速恢复术后视力,术后反应轻,减少术后并发症。

Phacotrabeculectomy:results of 2.8mm scleral tunnel incision

·AIM: To report the results of phacotrabeculectomy with 2.8mm scleral tunnel incision.·METHODS: Phacotrabeculectomy was performed through an identical 2.8mm scleral tunnel incision in 52 eyes of 49 patients with cataract and glaucoma. The incision was closed with out suture. Foldable intraocular lens was implanted in all eyes.·RESULTS: The control of intraocular pressure on 36 eyes was desirable. The average postoperative intraocular pressure was (8.24±3.61)mmHg, (13.22±4.12) mmHg, (12.11±4.23)mmHg and (12.59±4.26)mmHg at one week, one month, three months and six months. As compared with 56 eyes in which phacotrabeculectomy was performed with 5.5mm scleral tunnel sutureless incision, there was no statistical difference, between the two, regarding the mean postoperative intraocular pressure at six months (t=1.7536,P=0.08239).The retinal nerve fiber layer thickness was not statistically different between the preoperative and postoperative times in one year in 26 eyes. The uncorrected postoperative visual activity was 0 8 or better in 62% of 52 eyes.·CONCLUSION: The advantages of this operative method are minimal size scleral flap, smaller and sutureless incision, immediate chamber restoration, decrease in postoperative astigmatism, enhanced postoperative visual activity, reduced postoperative inflammatory response and complications.