原发性急性闭角型青光眼合并白内障的联合治疗

目的探讨氪激光及Nd：YAG激光虹膜成形加打孔术联合超声乳化手术治疗原发性急性闭角型青光眼合并白内障的临床意义。方法对25例（25眼）急性闭角型青光眼合并白内障首次发作者，药物控制眼压后即行Nd：YAG激光及氪激光虹膜成型及打孔术，术后3～14d行超声乳化吸出联合人工晶状体植入术，观察治疗前及术后眼压、前房深度及视力，并用StratusOCT观察房角情况。随访3～12个月，结果采用配对t检验，SPSS10．0统计学方法分析。结果眼压由术前的（62．17±14．12）mmHg降至（14．32±3．17）mmHg，前房深度由术前（1．67±0．32）mm加深至（2．86±0．40）mm，房角明显加宽，术后视力明显提高。结论对首次发作的急性闭角型青光眼合并白内障，激光虹膜成形及打孔术联合白内障超声乳化手术可以有效的控制眼压，开放房角，提高视力。减少青光眼外滤过手术的并发症，减少创伤，改善视力，提高生活质量。

Clinical study on the therapeutic alliance of acute angle-closure glaucoma with cataract

Objective To investigate the clinical significance of phacoemulsification combining initial iridoplasty by krypton and iridectomy by Nd:YAG laser treatment for cataract with acute angle closure glaucoma. Methods twenty-five eyes of 25 cases with first attack of acute angle-closure glaucoma with cataract were treated by initial laser iridoplasty and iridectomy after intraocular pressure controlled equability,followed by phacoemulsification and intraocular lens implantation after 3-14 days. The intraocular pressure,anterior chamber depth, visual acuity were observed, and the appearance of anterior chamber angle were found by Stratus OCT. Results From initial condition to after-operation, Intraocular pressure was decreased obviously from 62.17 ± 14. 12 mmHg to 14.32 ± 3. 17 mmHg. Anterior chamber depth changed from 1.67 ± 0.32 mm to 2.86 ± 0.40 mm, and the anterior chamber angle open widely. All patients had improved visual acuity. Conclusions To attack of acute angle-closure glaucoma combined with cataract, laser iridoplasty and iridectomy with followed phacoemulsification can effectively control the intraocular pressure,open the angle of anterior chamber, and improve visual acuity. It can reduce complications of glaucoma filtrating surgery, reduce the probability of trauma, improve vision, and improve quality of life.