同轴微切口白内障超声乳化联合微型青光眼引流器植入术临床疗效观察

目的观察同轴1．8mm微切口超声乳化联合微型青光眼引流器植入术治疗青光眼伴白内障的效果。方法对30例（30只眼）开角型青光眼伴白内障患者采用Steltaris微切口超声乳化仪吸除白内障，同时用Ex—PRESS推注系统EDS植入Ex—PRESSP50微型引流器。术后观察眼压、视力、术后并发症；平均观察（4．21±2．16）个月。结果随访期间内，有27只眼的眼压稳定在（13．57±3．31）mmHg（1mmHg=0．133kPa），其余3只眼在随访期间需滴用一种抗青光眼药物，眼压均控制良好。术前视力：光感至0．15。术后矫正视力：30只眼中0．1～0．2者3只眼（10．0％），0．3～0．4者8只眼（26．7％），0．5～0．8者12只眼（40．0％），0．8～1．O者5只眼（16．7％）。其中〉1．0者2只眼（6．7％）。所有术眼在手术过程中均前房稳定，未见明显角膜切口热损伤，无后囊破裂、视网膜脱离及滤过泡损伤等严重并发症的发生，术后未出现脉络膜脱离、浅前房和低眼压等。结论微切口白内障超声乳化联合微型青光眼引流器植入术是一种安全有效的手术方式，它使手术趋于简单、安全，视力恢复快，较传统超声乳化联合小梁切除术后的并发症减少。

Clinical outcome of micro-incision coaxial phacoemulsification with miniature glaucoma drainage device implantation

OBJECTIVE To observe the clinical outcome of 1.8 mm micro-incision coaxial phaeoemulsifieation with miniature glaucoma drainage device implantation were treating glaucoma with cataract. METHODS Thirty （30 eyes） presenting open-angle glaucoma with cataract treated by the surgery. Cataract was removed by phacoemulsifieation using a Stellaris phaeo unit through the incision of 1.8 ram, followed by Ex-PRESS Mini Glaucoma Shunt injection. During the postoperative follow up, intraoeular pressure （IOP）, visual acuity, and postoperative complications were recorded. Average observed （4.21± 2.16） months. RESULTS During follow-up, 27 patients＇ IOPs were stable without any anti-glaucoma drug, mean 13.57 ±3.31 mmHg （1 mmHg = 0.133 kPa）. The other three patients still required one anti-glaucoma eye drop, and IOPs were controlled well. Preoperative visual acuity was light perception to 0.15. Postoperative corrected visual acuity was 0.1 to 0.2 in 3 eyes （10.0%）, 0.3 to 0.4 in 8 eyes （26.7%）, 0.5 to 0.8 in 12 eyes （40.0%）, 0.8 to 1.0 in 5 eyes （16.7%）, 〉 1.0 in 2 eyes （6.7%）. No intraoeular or postoperative complications were observed. CONCLUSIONS Micro-incision phaeoemu]sification with mini glaucoma drainage device implantation was a safe and effective surgical approach. Compared with the conventional phacoemulsifieation with trabeculectomy, the new surgery processing was much easier and safer, with faster visual acuity recovery and less complication.