白内障超声乳化吸除联合房角分离术治疗闭角型青光眼的临床观察

目的观察超声乳化白内障吸除联合房角分离术治疗闭角型青光眼合并白内障患者的临床疗效。方法收集2008年7月至2011年12月闭角型青光眼合并白内障34例（35只眼），患者均接受采用颞侧隧道式角膜透明切口，超声乳化白内障吸除联合房角分离术，术后随访6个月。结果术后最佳矫正视力，较术前显著提高（t=3．951，P〈0．01）；患者术后6个月眼压平均为（14．2±2．8）m／nHg，较术前用药前后眼压相比均显著下降（t=3．228，P〈0．01）；术后患者房角均较术前增宽，房角粘连关闭象限不同程度开放；术前前房深度为（3．65±0．23）mm，术后增加到（4．60±0．35）mm，差异有显著性（t=2．349，P〈0．05）；未发生恶性青光眼、后囊膜破裂等并发症；所有术眼人工晶状体均在位，未出现偏位、夹持。结论白内障超声乳化吸除联合房角分离术可有效降低眼压，提高视力，为闭角型青光眼同时合并白内障患者安全有效的治疗途径。

Clinical observation on the effect phacoemulsification combined with goniosynechinlysis on angle closure glaucoma

Objective To observe the ettlcacy of phacoemulsification combined with goniosynechialysis to treat angle closure glaucoma with cataract. Methods This is a retrespective study. Thirty-five eyes of 34 patients with angle closure glaucoma and cataract were admitted to our hospital from July 2008 to December 2011. Patients underwent goniosynechialysis and phacoemulsification and IOL implantation. Followed up continued for six months. Results The best-corrected visual acuity improved after surgery （ t = 3. 951, P 〈0.01 ）. The average intraocular pressure at 6 months was 14.2 ± 2.8 mm Hg, significantly lower than prcoperative IOP （ t = 3. 228, P 〈 0.01 ）. Central and peripheral anterior chamber depth significantly increased after the surgery, and peripheral anterior chamber reopened in more quadrants. No malignant glaucoma, rupture of lens capsule or lOP displacement was reported during the follow-up. Conclusion Goniosynechialysis combined with phacoemulsification and IOL implantation can decrease intraocular pressure and improve visual acuity. It safe and effective for the treatment of angle closure glaucoma complicated with cataract.