老年性白内障膨胀期继发性青光眼手术治疗探讨

目的探讨老年性白内障膨胀期继发性青光眼的手术方式、手术时机。方法筛选白内障膨胀期继发性青光眼病人30例（30只眼）,行单纯白内障手术12只眼（其中白内障囊外摘除术6只眼,超声乳化白内障吸除术6只眼）,白内障联合抗青光眼手术18只眼（其中小梁切除术12只眼,周边虹膜切除术6只眼）。一期联合人工晶状体植入术20只眼。结果术后27只眼（90.0%）眼压正常,3只眼需使用降眼压药物方可控制眼压;术后矫正视力提高者28只眼（93.3%）,矫正视力≥0.3者占66.7%。结论尽早选择恰当的手术方式治疗老年性白内障膨胀期继发性青光眼可以提高视力和控制眼压,膨胀期白内障手术是预防老年性白内障膨胀期继发性青光眼的重要措施。

SURGICAL TREATMENT OF SECONDARY GLAUCOMA DUE TO INTUMESCENT SENILE CATARACT

Objective To investigate the surgery and options for secondary glaucoma due to intumescent senile cataract （SGISC）. Methods Thirty SGISC eyes （30cases） were selected, in which, cataract extraction only was performed in 12 eyes （six by extra-capsular extraction, and six by phacoemulsification）. A combination of cataract extraction and antiglaucoma surgery was done in 18 eyes （12 combined with trabeculectomy, six with periphery iridectomy）. Twenty eyes in the 30 were combined with posterior chamber foldable intraocular lens implantation at the first surgery. Results Postoperatively, intraocular pressure was normal in 27 eyes （90.0%）, three eyes needed anti-glaucoma drugs; visual acuity, 28 eyes improved （93.3%）, and the corrected vision ≥0.3 accounted for 66.7 %. Conclusion Properly operative options can improve vision and control intraocular pressure. An important step for prevention of glaucoma secondary to cataract intumescent stage is to have a surgery before this stage.