超声乳化白内障吸除术治疗晶体溶解性青光眼7例临床分析

目的 探讨白内障防盲筛查中晶体溶解性青光眼的临床特点及治疗方法，以提高对本病的认识。方法 对7例最终确诊为晶体溶解性青光眼的临床资料进行分析。入院明确诊断后，给予超声乳化白内障手术摘除晶状体，术后随访3个月。结果 均为老年患者，门诊初诊为晶体溶解型青光眼4例，葡萄膜炎继发青光眼2例，年龄相关性白内障过熟期1例，该患者行散瞳检查后遂出现晶体囊膜破裂皮质溶解，临床表现与另6例大致相同。6例术后第1天眼压降至正常，1例术后3d眼压为30~42 mmHg，经多次前房放液及降眼压药物治疗，术后2周逐渐停用所有降眼压药物，眼压恢复至正常。视力因病程及眼底情况不同恢复不一致，但均较术前提高。结论 ①晶体溶解性青光眼在患者刚就诊时不易确诊；②前房冲洗后行白内障摘除为治疗晶体溶解性青光眼的有效方式；③落后地区仍然存在较多白内障过熟期患者，应加强宣传，使患者远离继发性青光眼损害。

Clinical analysis of 7 patients with phacolytic glaucoma treated by phacoemulsification

Objective To explore the clinical characteristics and treatment method of cataract blindness screening crystal solubility in glaucoma. Methods The clinical data of 7 cases diagnosed as crystal solubility glaucoma were retrospectively analyzed. Admitted to hospital after diagnosis, they were given phacoemulsification to remove the lens. Results There were crystals dissolve glaucoma in 4 cases, uveitis secondary glaucoma in 2 cases, and age-related cataract overmature in 1 case which had specialized examination after hence dissolved lens membrane rupture cortex. 6 cases had their postoperative intraocular pressure decreased to normal in 1 day, 1 case had the postoperative intraocular pressure decreased to 30 to 42 mmHg in 3 days and had it gradually be back to normal after repeated anterior chamber fluid and drug treatment in 2 weeks. Followed up in 3 months, visions were all increased. Conclusion Crystal solubility in glaucoma patients is difficult to be diagnosed. Anterior chamber irrigation after cataract extraction is the effective way for crystals dissolve glaucoma. There are still more patients with cataract overmature period in the backward area.