超声乳化联合房角分离术治疗闭角型青光眼术后合并白内障

目的观察超声乳化白内障吸出后房型人工晶状体植入术联合房角分离术治疗原发性闭角型青光眼患者小梁切除术后合并白内障患者的临床疗效。方法前瞻性研究方法。纳入符合条件的手术患者35例（38只眼），行透明角膜切口白内障超声乳化吸除联合后房型人工晶状体植入术并房角分离术，随访6个月至1年，比较观察手术前后视力、眼压情况、中央前房变化情况和房角开放情况。结果所有患者术后视力均有提高。患者术前平均眼压（16．91±3．44）mmHg，术后平均（11．82±2．52）mmHg，差异有统计学意义（P〈0．05）；术前中央前房深度平均（2．10±0．19）mm，术后平均（3．31±0．28）mm，差异有统计学意义（P〈0．05）。术前周边前房深度〈1／2 CT者29只眼，术后28只眼周边前房深度≥1CT。术后房角关闭所在象限均有不同程度的开放，周边虹膜粘连范围明显缩小。2只眼前房出血，3只眼前房渗出，1只眼发生后囊膜破裂，无恶性青光眼、角膜失代偿等并发症。结论超声乳化自内障吸出人工晶状体植入术联合房角分离术治疗青光眼合并白内障患者可有效的降低眼压。

Clinical study of phacoemulsification with goniosynechialysis for the treatment of primary angle-closure glaucoma after trabeculectomy with complicated cataract

Objective To investgate the clinical effect of phacoemulsification combined with go niosynechialysis on primary angle-closure glaucoma after trabeculectomy with complicated cataract.Methods It was a prospective randomized clinical trial.There were 35 cases(38 eyes),diagnosed primary angle-closure glaucoma(PACG) with cataract in our hospital.All patients were undergone phacoemulsification and intraocular lens(IOL) implantation,combined with goniosynechialysis.The best corrected visual acuity(BCVA) before and after operation、intraocular pressure(IOP)、the central anterior chamber(CAC) depth and the change of anterior chamber angle were all observed and reported.The time of following-up was 6 to 12 months.Results All patients BCVA were improved after operation.Preoperative mean IOP is(16.91±3.44) mm Hg,while the postoperative IOP were(11.82±2.52) mm Hg,The IOP were obviously decreased after operation(P<0.05).Preoperative mean CAC depth is(2.10±0.19)mm,while the postoperative CAC depth were(3.31±0.28)mm,The CAC depth were obviously decreased after operation(P<0.05).There were 29 eyes whose preoperative CAC depth were less then 1/2CT.There were 28 eyes whose postoperative CAC depth were more than 1CT.The angle-closure can be partly opened.Iris adhesion around the significant reduction.2 cases anterior chamber bleeding,3 cases cellulose sexual exudate in the anterior chamber.Posterior capsular rupture occurred in 1 eye,no malignant glaucoma,corneal decompensated complication.Conclusion The threatment of primary angle-closure glaucoma after trabeculectomy with cataract by phacoemulsiflcation combined with goniosynechialysis can be reduce intraocular pressure,improve visual acuity.