三联术在急性闭角型青光眼合并白内障治疗中的应用

目的 评价小切口白内障囊外摘除人工晶状体植入联合小梁切除术治疗急性闭角型青光眼合并白内障患者的安全性和有效性.方法 对29例（29眼）急性闭角型青光合并白内障患者,在眼压控制正常、稳定,皮质类固醇局部抗炎,葡萄膜炎症得到显著控制后,行小切口白内障囊外摘除人工晶状体植入联合小梁切除术,术后随访6～12个月.结果 术后眼压正常,视功能较术前有不同程度的改善.术中并发症有剪除周边虹膜时少量出血,术后并发症有角膜水肿（后弹力层皱褶）、葡萄膜炎、人工晶状体表面渗出膜等,无暴发性脉络膜出血、前房延缓形成、角膜失代偿、睫状环阻滞性青光眼等并发症发生.结论 急性闭角型青光眼合并白内障患者,在眼压正常、葡萄膜炎症控制后,行小切口白内障囊外摘除人工晶体植入联合小梁切除术,对控制患眼眼压,减少术后前房延缓形成,角膜失代偿等并发症的发生,以及不同程度的保护和恢复视功能方面有积极的意义和较好的临床效果.本手术是安全和有效的,且费用低廉,尤其适合基层开展.

Application of triple surgery for the treatment of acute angle-closure glaucoma complicated with cataract

Objetive The purpose of this study is to evaluate the safety and validity of the surgery that the small incision extracapsular cataract extraction and intraocular lens implantation combined with trabeeuleetomy for patients suffering from acute angle-closure glaucoma complicated with cataract. Methods In the condition of normal and steady intraocular pressure and the effective control of uveitis, the 29 patients （eyes） with acute angle-closure glaucoma complicated with cataract were treated with small incision extraeapsular cataract extraction and intraocular lens implantation and trabeculeetomy, and followed up for 6 ~ 12 months. Results The patients＇ normal intraocular pressure remained, and the visual function was improved after treatment. The was tiny bleeding caused by bullonhole irideetomy. The post-operative complications included corneal edema （deseemet membrane fold）, uveitis, exudation on the intraocular lens surface, et al. Explosive choroidal hemorrhage, flat anterior chamber, corneal decompensation, and malignant glaucoma did not occurred. Conclusion the surgery that the small incision extraeapsular cataract extraction and intraoeular lens implantation combined with trabeeulectomy can control intraocular pressure, decrease the occurrence of complications such as flat anterior chamber and corneal decompensation, protect and recover visual function for those patients whose intraoeular pressure was normal and uveitis had been controlled. The surgery is safe and effective and also cheap, therefore, it is especially suitable to be implemented in the primary hospitals.