抗青光眼滤过术后患者白内障超声乳化吸除及人工晶状体植入术

目的：探讨抗青光眼滤过术后白内障患者进行白内障超声乳化吸除及人工晶状体植入术的手术切口选择和临床效果。方法：32例（41只眼）青光眼滤过术后的白内障患者，采用上方透明角膜隧道切口和避开滤过泡的巩膜隧道切口行白内障超声乳化吸除，植入折叠式人工晶状体24只眼，硬性人工晶状体17只眼。结果：全部白内障术后病例视力有不同程度的提高，视力≥0．5者达75．6％。采用透明角膜隧道切口和巩膜隧道切口术后患者的眼压和滤过泡改变无差异性，术后随访平均5个月，平均眼压较术前增加1．59mmHg(1mmHg=0.133kPa)，差异无显著性。结论：对抗青光眼滤过术后白内障患者，采用透明角膜和巩膜隧道切口行白内障超声乳化吸除及人工晶状体植入术，可提高视力，同时可保持原有的滤过功能。

Phacoemulsification with intraocular lens implantation in glaucomatous patients after filtering surgery

Objective:To investigate the choice of surgical incision and the clinical effects of phacoemulsification with intraocular lens implantation in glaucomatous patients after filtering surgery.Methods:Phacoemulsification and implantation with foldable and rigid intraocular lens were performed on 41 eyes with a preexisted filtering bleb,and a clear corneal or scleral tunnel incision was selected.Results:The postoperative visual acuities of all patients improved in different degrees,and in 31 eyes(75 6%) the vision was 0 5 or better.There was no stastic significance in patients' IOP and filtering blebs between groups with clear corneal or scleral tunnel incision.The postoperative IOP increased 1 59mmHg(1mmHg=0 133kPa).Conclusions:Glaucomatous patients with cataract after filtering operation can rehabilitate their visual acuity and maintain the functional filtering bleb by phacoemulsification and implantation with foldable or rigid intraocular lens through a clear corneal or scleral tunnel incision.