青光眼白内障联合手术治疗青光眼合并白内障

目的　探讨3种不同切口三联手术治疗青光眼合并白内障的效果。方法　将2 4例(2 6眼)青光眼合并白内障分为3组:11眼采用常规巩膜瓣下小梁切除联合白内障囊外摘出人工晶状体植入术;9眼采用小切口隧道式巩膜瓣小梁切除联合超声乳化吸出及后房人工晶状体植入术;6眼采用透明角膜切口超声乳化联合后房人工晶状体植入术及房角分离术。观察术后视力、眼压及并发症。结果　随访3月,术后平均眼压(15 . 12±3 . 42 )mmHg(1mmHg =0 .13 3kPa) ,与术前平均眼压(2 6 .5 0±4 .92 )mmHg比较有了明显下降,差异有显著性意义(t =0 . 897,P <0 .0 0 1) ;视力明显提高;并发症有角膜水肿(19. 2 3 % )及后囊浑浊(11. 5 3 % )。结论　青光眼白内障联合手术(三联手术)是治疗白内障合并青光眼的一种有效的方法。

Trabeculectomy combined with cataract extraction and intraocular lens implantation for treatment of glaucoma complicated with cataract

Objective To evaluate the therapeutic effect of the trabeculectomy combined with cataract extraction and intraocular lens implantation (triple procedure) and compare the outcomes of the operation with three different incisions. Methods Triple procedure was performed on 26 eyes of 24 patients with cataract and glaucoma. Cataract extraction, intraocular lens implantation and trabeculectomy were performed by means of conventional scleral flap on 11 eyes. Phacoemulsification, intraocular lens implantation and trabeculectomy were performed through a small incision by means of scleral tunnel flap on 9 eyes. Phacoemulsification, foldble intraocular lens implantation and goniosynechialysis were performed through a small incision by means of clear cornea tunnel flap on 6 eyes. We observed the postoperative visual acuities, the mean intraocular pressure (IOP) and other complications. Results After a postoperative follow-up of 3 months, the intraocular pressure (IOP) was reduced from a preoperative mean of (26.50 4.92)mmHg to a postoperative mean of (15.12 3.42)mmHg (t=0.897,P<0.001).The best corrected visual acuity was improved. Complications were posterior corneal edema (19.23 %) and posterior capsular cataract (11.54% ). Conclusion The triple procedure is an effective, quick and safe procedure for cataract patients with glaucoma. There are no differences at the surgical outcome of three different incisions.