超声乳化人工晶状体植入联合房角分离术治疗闭角型青光眼合并白内障

目的：探讨超声乳化人工晶状体植入术联合房角分离术治疗闭角型青光眼合并白内障的临床效果，为治疗闭角型青光眼合并白内障提供依据。

方法：回顾分析2010-01/2011-10入选本研究的95例112眼闭角型青光眼合并白内障患者的临床资料，对其行超声乳化白内障摘除人工晶状体植入术联合房角分离术治疗，对其疗效进行分析，观察治疗前后视力、眼压、前房深度、房角的变化及并发症的情况。计量资料采用配对t检验进行分析。

结果：术前视力、眼压、前房深度分别为0.14±0.18，34.5±6.5mmHg，1.51±0.27mm； 术后1wk； 1，6mo视力分别是0.61±0.14，0.61±0.2，0.60±0.151； 术后1wk； 1，6mo眼压分别是13.1±3.7，12.8±3.9，12.9±4.3mmHg； 前房深度为2.49±0.3 1，2.45±0.39，2.46±0.43mm； 术后1wk； 1，6mo的眼压明显低于术前眼压，视力、前房深度、房角变化在手术前后具有显著的差异(P<0.05)。术后不同的时段，各参数之间均无显著的差异。房角镜检查：112眼房角均完全开放。术后浅前房、高眼压率及前房炎症反应等均得到及时有效的治疗。

结论：超声乳化白内障摘除人工晶状体植入联合房角分离术治疗白内障合并闭角型青光眼可明显地提高视力，安全有效、方便快捷、并发症少，可广泛运用。

Treatment effect for cataract and angle-closure glaucoma with phacoemulsification and intraocular lens implantation combined with goniosynechialysis

AIM: To observe the clinical effect of phacoemulsification and intraocular lens implantation combined with goniosynechialysis in the treatment of cataract and angle-closure glaucoma. To provide a reliable method for the treatment of cataract patients with angle-closure glaucoma.

METHODS: A retrospective analysis included clinical data of 95 patients(112 eyes)with cataract and angle-closure glaucoma which came from our hospital from Jan 2010 to Oct 2011. The patients were treated with phacoemulsification and intraocular lens implantation combined with goniosynechialysis. The clinical effect was compared between before and after treatment. The following clinical parameters were tested before and after treatment: visual acuity, intraocular pressure(IOP), anterior chamber depth, angle changes, and incidence of complications. Pair t test was used to analyze the measurement data.

RESULTS: The postoperative IOP of these patients was significantly lower than the preoperative at 1wk; 1, 6mo. There was significant difference between before and after treatment concerning visual acuity, anterior chamber depth, and angle changes(P<0.05). At different periods after treatment, all parameters of patients showed no significant differences. Comparison of the efficacy of before and after operation, chamber angle examination: all the subjects'(112 eyes)angle completely open after operation; the visual acuity, IOP, anterior chamber depth were 0.14±0.18, 34.5±6.5mmHg, 1.51±0.27mm respectively at pre-operation; after operation of 1wk; 1, 6mo, the visual acuity were 0.61±0.14, 0.61±0.2, 0.60±0.151 respectively; at 1wk; 1, 6mo of postoperation, the IOP were 13.1±3.7, 12.8±3.9, 12.9±4.3mmHg, and anterior chamber depth were 2.49±0.31, 2.45±0.39, 2.46±0.43mm. There were statistical differences at pre- and post-operation. Shallow anterior chamber, intraocular hypertension rate, and anterior chamber inflammation were treated efficiently and timely.

CONCLUSION: Phacoemulsification and intraocular lens implantation combined with goniosynechialysis in the treatment of cataract patients with angle-closure glaucoma can significantly improve visual acuity and reduce early complications of operation. It's safe, effective and convenient. The method of operation can be widely used.