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白内障超声乳化联合人工晶状体植入术治疗闭角型青光眼合并白内障的疗效观察(1)
http://www.100md.com 2012年9月25日 杨咏
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     [摘要] 目的 观察白内障超声乳化联合人工晶状体植入术治疗闭角型青光眼合并白内障的临床疗效,以期为临床治疗提供理论支持。 方法 我院于2010年2月~2012年1月采用白内障超声乳化联合人工晶状体植入术治疗闭角型青光眼合并白内障50例80只眼,观察术后的视力情况、眼压及前房深度、并发症情况。 结果 术后随着随访时间的延长,患者术后的视力逐渐改善。术后3个月最佳矫正视力≥0.5达80.0%。术后眼压较术前明显降低,而前方深度术后较术前明显增加,差异有统计学意义(P < 0.05)。 结论 采用白内障超声乳化联合人工晶状体植入术治疗闭角型青光眼合并白内障能明显改善患者的视力,且并发症少,值得推广和应用。

    [关键词] 闭角型青光眼;白内障;超声乳化联合人工晶状体植入术

    [中图分类号] R779.6 [文献标识码] B [文章编号] 1673—9701(2012)27—0033—02

    Efficacy of phacoemulsification and intraocular lens implantation in the treatment of angle—closure glaucoma and cataract

    YANG Yong

    Department of Ophthalmology, Zhejiang Jinhua City Central Hospital, Jinhua 321000, China

    [Abstract] Objective To observe the clinical efficacy of phacoemulsification with intraocular lens implantation in the treatment of angle—closure glaucoma and cataract, in order to provide theoretical support for clinical treatment. Methods From February 2010 to January 2012 using the 50 cases, 80 eyes, phacoemulsification with intraocular lens implantation in the treatment of angle—closure glaucoma and cataract and observed postoperative visual acuity, intraocular pressure and anterior chamber depth complications. Results With the extension of the follow—up time after surgery, postoperative visual acuity gradually improved. After 3 months the best corrected visual acuity ≥ 0.5 up to 80.0%. The postoperative IOP was significantly lower than the preoperative, after the front depth increased significantly compared with the preoperative and the difference was statistically significant (P < 0.05). Conclusion Phacoemulsification with intraocular lens implantation in the treatment of angle—closure glaucoma and cataract can significantly improve patients' vision and have fewer complications, worthy of promotion and application.

    [Key words] Angle—closure glaucoma; Cataract; Phacoemulsification with intraocular lens implantation

    闭角型青光眼是由于房角关闭,房水外流受阻,引起眼压升高的一类青光眼疾病[1]。随着年龄增长及长期应用缩瞳剂,闭角型青光眼常同时存在白内障[2]。我院于2010年2月~2012年1月采用白内障超声乳化联合人工晶状体植入术治疗闭角型青光眼合并白内障50例80只眼,取得了较好的效果,现报道如下。

    1 资料与方法

    1.1 临床资料

    我院2010年2月~2012年1月收治的50例(80眼)闭角型青光眼合并白内障患者,其中男33例(40眼),女17例(40眼),年龄50~81岁,平均66.2岁;所有患者术前行常规房角镜检查,动态下所有房角开放>1/2。术前均进行视力、最佳矫正视力、眼压测量、裂隙灯检查、前房角镜检查及常规全身检查,超声检查排除视网膜脱离、玻璃体混浊等情况。

    1.2 手术方法

    术前扩瞳,表面麻醉。患眼均作颞上方透明角膜隧道切口和角膜缘辅助切口,前房内注入黏弹剂,连续环形撕囊,注入平衡液,核—皮质水分离,超声乳化机行晶体核原位乳化吸出。抽吸皮质,扩大内切口后,囊袋内植入人工晶状体。置换出黏弹剂,结膜瓣复位,检查切口不漏水,结膜下注射妥布霉素和地塞米松。

    1.3 观察指标

    观察术后3 d及术后3个月的视力改善情况、眼压及前房深度、并发症情况。前房深度用Suoer眼科A超测术前、术后中央前房深度,每眼取10次的平均值。

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