超声乳化白内障吸除折叠式人工晶状体植入联合青光眼小梁切除术

目的 评价３．５ｍｍ小切口超声乳化白内障吸除折叠式人工晶状体（ｉｎｔｒａｏｃｕｌａｒ ｌｅｎｓ,ＩＯＬ）植入联合小梁切除术（三联手术）的安全 及有效性,并比较常规巩膜瓣和隧道巩膜瓣２种小切口三联手术的效果。方法 采用上方３．５ｍｍ常规巩膜瓣或隧道巩膜瓣切口对４２例（４４只眼）白内障合并联手术的效果。方法 采用上方３．５ｍｍ常规巩膜瓣或隧道巩膜瓣切口对４２例（４４只眼）白内障合并青光眼患者行三联手术

Combined phacoemulsification, foldable intraocular lens implantation and trabeculectomy for cataract patients with glaucoma

OBJECTIVE: To evaluate the therapeutic effects and safety of the combined phacoemulsification, foldable intraocular lens implantation and trabeculectomy (triple procedure) and compare the outcomes of the operation with two different small incisions, conventional scleral flap and scleral tunnel flap. METHODS: Triple procedure was performed through a 3.5 mm incision by means of conventional scleral flap or scleral tunnel flap on 44 eyes of 42 patients with cataract and glaucoma. RESULTS: After follow-up for 3 -- 6 months, the mean intraocular pressure (IOP) was (14.33 +/- 3.68) mm Hg (1 mm Hg = 0.133 kPa) with a mean pressure reduction of 10.35 mm Hg from that before the operation (P < 0.001). Postoperatively, the visual acuities were >or= 0.5 in 33 eyes (75.0%) at 1 week and in 37 eyes (84.1%) during 3 - 6 months. The mean postoperative astigmatism was (1.29 +/- 0.93) D at 1 week and only 0.17D more than the mean preoperative one (P > 0.05). There was also no statistical difference between the mean preoperative astigmatism and postoperative astigmatism at 3 - 6 months, which was (1.12 +/- 0.73) D. The filtering blebs of type I and II (functional) by Kronfeld's classification presented in 79.5% of the eyes and type III (non-functional) in 20.5% of the eyes. There were no statistical differences for the postoperative outcomes of IOP, visual acuity, astigmatism and filtering bleb between two different procedure groups (P > 0.05). CONCLUSIONS: The triple procedure is an effective, quick, repeatable and safe procedure for cataract patients with glaucoma. There are no differences at the surgical outcomes of two different incisions by means of the conventional scleral flap vs scleral tunnel flap.