小切口白内障手术联合隧道内小梁切除术治疗白内障青光眼26例临床疗效观察

目的：探讨小切口白内障手术联合隧道内小梁切除术治疗白内障青光眼临床疗效。方法对26眼白内障合并青光眼的患者,行小切口白内障摘除人工晶体植入联合小梁切除术,术后观察术眼视力、眼压、滤过泡、并发症等情况,术后随访6个月。结果术后6个月随访时,23眼（88.5%）术后视力有不同程度的提高,其中术后视力大于0.3有19眼（73.1%）。术前及术后各观察时间点眼压值比较发现,术后眼压均比术前有所下降,差异有统计学意义（P〈0.05）；术后各观察时间点眼压值两两比较发现,差异均无统计学意义（P〉0.05）。术后有23眼（88.5%）形成弥漫扁平的功能性滤过泡,其中Ⅰ型滤过泡14眼,Ⅱ型滤过泡9眼。术后有角膜水肿7眼,浅前房3眼,术中术后未见严重的并发症。结论小切口白内障手术联合隧道内小梁切除术治疗白内障合并青光眼,不但能很好的控制眼压,迅速恢复视力,而且并发症少,该方法是一种安全、有效、经济、实用的手术方法,值得临床应用。

Observation on clinical effect of small incision cataract surgery combined tunnel trabeculectomy for the treatment of 26 cases of patients with cataract and glaucoma

Objective To investigate the effect of combined surgery of improved small incision intraocular lens implantation and glaucoma. Methods Combined surgery were performed on 26 eyes of cataract with glaucoma, the postoperative visual acuity, intraocular pressure, filtering bleb and complication were investigated after follow-up 6 months. Results 23 eyes（88.5%） had improved visual acuity. 19 eyes（73.1%） had the best corrected visual acuity〉0.3. Surgery before and after each observation time point IOP found postoperative IOP than preoperative decline, the difference was statistically mathematical significance（P〈0.05）;postoperative each observation time point IOP pairwise comparisons statistical mathematical significance（P〈0.05）. 23 eyes （88.5%） had the functional filtering bleb,Ⅰtype filtering bleb in 14 eyes,Ⅱtype filtering bleb in 9 eyes, Cornea edema occurred in 7 eyes, shallow anterior chamber occurred in 3 eyes. No serious complication occurred in or after operation. Conclusion Combined surgery could control IOP effectively and restore acuity early with less complication. It is a safe effective and economic method and worth expanding.