抗青光眼滤过术后超声乳化白内障吸除术的临床观察

目的　探讨抗青光眼滤过手术后进行白内障手术的方法及手术对滤过泡的影响。方法对抗青光眼小梁切除术后白内障患者 2 35例 (2 6 2只眼 ) ,采用颞侧透明角膜隧道切口进行超声乳化白内障吸除及折叠式人工晶状体植入手术 ,同时对固定的小瞳孔进行扩张或采用括约肌切开与缝合术。结果　白内障术后患者视力不同程度提高 ,视力≥ 0 5者占 74 0 % ;术后平均眼压升高 3 0 8mmHg(1mmHg =0 133kPa) ,与术前比较差异无显著性 (P >0 0 5 ) ;功能性滤过泡未见明显瘢痕化。结论　对抗青光眼滤过术后白内障患者进行颞侧透明角膜隧道切口超声乳化白内障吸除术 ,可提高视力 ,同时可保持滤过泡功能。

Phacoemulsification with silicone foldable intraocular lens implantation through a small incision in glaucomatous eyes after filtering surgery

OBJECTIVE: To investigate the method of cataract extraction in eyes that had undergone glaucoma filtering surgery and its effects on filtering bleb. METHODS: Phacoemulsification with posterior chamber intraocular lens implantation was performed on 262 eyes with a preexisting filtration bleb, in which at the temporal clear cornea a lateral or inferior lateral limbal incision was selected, the pupil sphincter was cut and the iris was sewed for the small and fixed pupil. RESULTS: The postoperative visual acuity of all patients improved in different degrees, with >or= 0.5 in 74.0% in the first month. The postoperative IOP increased by 3.08 mmHg. The functional filtering bleb was not apparently cicatrized. CONCLUSIONS: Glaucomatous eyes with cataract after filtering operation can rehabilitate their visual acuity and maintain the functional filtering bleb by phacoemulsification with foldable intraocular lens implantation through a temporal clear corneal incision or lateral scleral pocket incision. Theoretically, the effect of a transparent corneal incision on filtering bleb is less than that of a scleral pocket incision.