超声乳化白内障摘除治疗合并白内障的可疑房角关闭和房角关闭及原发性闭角型青光眼

目的: 观察白内障超声乳化摘除联合人工晶状体植入术治疗伴有白内障的可疑原发性房角关闭(PACS)、原发性房角关闭(PAC)及原发性闭角型青光眼(PACG)的特点及疗效。方法: 选取2012-01/12诊断为合并老年性白内障的PACS和PAC及PACG患者共86例86眼,均行白内障超声乳化摘除+人工晶状体植入术,术后随访3mo,术前术后记录视力、眼压、房角、超声生物显微镜检查(UBM)、视野及降眼压药物使用情况。结果: 术中发现19眼(22%)晶状体悬韧带不同程度松弛。84眼(98%)术后视力不同程度提高,术后视力<0.1者7眼(8%),0.1～0.5者32眼(37%),0.6～1.0者47眼(55%)。83眼(97%)随访期结束时不用药情况下眼压均在10～15mmHg之间。术后前房均加深,房角不同程度开放。结论: 悬韧带松弛在PACS,PAC,PACG中较为常见。超声乳化白内障摘除可有助于控制PAC及PACG患者的眼压,不同程度开放PAC及PACG房角、加深前房。

Phacoemulsification with intraocular lens implantation in primary angle-closure suspect, primary angle-closure and primary angle-closure glaucoma with cataract

AIM: To evaluate the features and clinical outcomes of cataract extraction by phacoemulsification with intraocular lens implantation in primary angle-closure suspect(PACS), primary angle-closure(PAC)and primary angle-closure glaucoma(PACG)with cataract.

METHODS:Phacoemulsification with intraocular lens implantation was performed on 86 cases(86 eyes)diagnosed as PACS, PAC and PACG co-existing cataract from January to December 2012. All cases were followed up for 3 months to 1 year. Pre-operative and post-operative visual acuity, intraocular pressure(IOP), gonioscopy, ultrasound biomicroscopy(UBM), visual field and usage of anti-glaucomaous eye drops were recorded.

RESULTS:Zonular dialysis existed in 19 eyes(22%). The post-operative visual acuity improved in 84 eyes(98%). The post-operative visual acuity was <0.1 in 7 eyes(8%), 0.1-0.5 in 32 eyes(37%), 0.6-1.0 in 47 eyes(55%). There were 83 eyes(97%)with IOP between 10-15mmHg without any drug at the end of the follow-up period. The central anterior chamber was deepened and the anterior angle opened postoperatively at different extent.

CONCLUSION: PACS, PAC and PACG co-existing zonular dialysis is common. Phacoemulsification with IOL implantation can reduce IOP, deepen anterior chamber and open angle.