白内障摘除治疗原发性闭角型青光眼的临床体会

目的探讨白内障摘除治疗原发性闭角型青光眼的治疗方法及临床疗效。方法回顾性分析芜湖市第二人民医院2008年1月-2010年6月连续就诊合并白内障的原发性闭角型青光眼患者11例(16眼)的临床资料,将该组患者按照眼压的大小分为两组,A组(≤30 mm Hg)10眼采用单纯小切口白内障摘除术+人工晶体植入术,B组(>30mm Hg)6眼采用行小切口白内障摘除术+人工晶体植入术+房角分离术。结果两组大部分患者房角较术前增宽,视野范围加大,眼压皆控制在正常范围。术前的平均眼压和前房深度为(35.4±3.7)mm Hg、(2.36±0.25)mm,术后为(14.8±2.8)mm Hg、(3.04±0.37)mm,术前、术后差异具有统计学意义,P<0.05。且术后最佳矫正视力较术前也有显著性的提高,P<0.05。结论白内障摘除治疗原发性闭角型青光眼的效果满意,具有降压和增视的双重效果,是一种有效、方便而完全的手术方法。

Clinical Experience with Cataract Extraction for Primary Angle-Closure Glaucoma

Objective To investigate the treatment and clinical efficacy of the cataract extraction for the primary angle-closure glaucoma.Methods The clinical data of 11 patients(16 eyes) with cataract and primary angle-closure glaucoma in our hospital from January 2008 to June 2010 were analyzed retrospectively.The patients were divided into Group A(≤30 mm Hg) and Group B(>30 mm Hg) according to the intraocular pressure of patients.The group A(10 eyes) was treated with simple incision cataract extraction and intraocular lens implantation,while the B group(6 eyes) with small incision cataract extraction and intraocular lens implantation and goniosynechialysis.Results The chamber angle was widened in most patients of the two groups,and the visual field was increased;The intraocular pressure were controlled within a normal range.The average intraocular pressure and anterior chamber depth were(35.4±3.7) mm Hg and(2.36±0.25) mm in preoperative;which were(14.8±2.8) mm Hg and(3.0 4±0.37) mm after surgery.The differences in preoperative and postoperative data were statistically significance(P<0.05).And the postoperative best corrected visual acuity were also improved significantly(P<0.05).Conclusion The efficacy of cataract extraction for the primary angle-closure glaucoma was satisfactory,it can not only decrease the intraocular pressure but also improve the visual acuity,it is an effective,convenient and complete surgical method.