白内障超声乳化术治疗闭角型青光眼的临床体会

目的：观察白内障超声乳化联合后房型折叠式人工晶状体植入术治疗合并白内障的不同房角关闭状态的闭角型青光眼的疗效。方法：白内障超声乳化联合后房型折叠式人工晶状体植入术治疗闭角型青光眼48例64眼,术前及术后常规行视力、裂隙灯、Goldmann前房角镜检查、前房深度、眼压检查。结果：术后随访3～12mo,52眼视力较前有明显提高。59眼术后眼压〈21mmHg。64眼前房深度均加深,术前前房深度平均1.803mm,术后前房深度平均3.143mm。术前关闭的前房角有不同程度的开放,虹膜平坦,虹膜周边前粘连的范围明显缩小。64眼均未发生后囊膜破裂及角膜失代偿。结论：合并白内障的闭角型青光眼患者行超声乳化白内障吸除联合折叠式人工晶状体植入术,不但能够有效降低眼压、加深前房、开放房角,还可恢复视功能,并能减少小梁切除术的常见并发症,是治疗闭角型青光眼的一种安全有效的方法。

Experience of phacoemulsification for treatment of angle-closure glaucoma

AIM:To report the results of phacoemulsification combined with posterior intraocular lens (IOL) implantation in treating angle-closure glaucoma with different severity of angle closure. METHODS:Phacoemulsification combined with posterior IOL implantation was performed in 64 eyes of 48 patients with angle-closure glaucoma. Visual acuity (VA), examination of anterior segment with slit-lamp microscope, examination of anterior chamber angle with Goldmann gonioscope, depth of anterior chamber and intraocular pressure (IOP) were recorded preoperatively and postoperatively. RESULTS:All the patients were followed up for 3 to 12 months. VA of 52 eyes were greatly improved. IOP of 59 eyes were below 21mmHg. Depth of anterior chamber all increased from average 1.803mm preoperatively to 3.143mm postoperatively. The closed anterior chamber angles were open to varying extents. The irises were flat and the extension of peripheral anterior chamber adhesion was eliminated obviously. None of the 64 eyes was complicated by posterior capsular rupture or corneal decompensation. CONCLUSION:Phacoemulsification combined with posterior IOL implantation in treating angle-closure glaucoma with cataract will not only effectively lower IOP, deepen the anterior chamber, reopen the closed anterior chamber angle, but also restore VA and reduce the common complications of trabeculectomy. It is a safe and effective way to treat angle-closure glaucoma.