摘要
目的观察小切口非超声乳化白内障摘除联合房角分离治疗急性闭角型青光眼合并白内障的疗效。方法选取40例(44眼)急性闭角型青光眼合并白内障患者,于2016年3月至2017年3月期间接受手术治疗,均予以小切口非超声乳化白内障摘除联合房角分离治疗,术后观察视力恢复情况,术后3个月的眼压,术前及术后3个月时采用A超声仪检查中央前房深度变化,并进行前房角镜检查,同时观察患者术后并发症发生情况。结果术后患者视力水平明显改善,与术前比较差异有统计学意义(P<0.001);术后3个月时,术眼眼压显著降低,前房深度显著加深,与术前比较差异有统计学意义(P<0.001);前房角镜检查显示,术后前房角显著增宽,与术前比较差异有统计学意义(P<0.001),术后3个月时,有31例(33眼)房角开放,7例(9眼)粘连范围在90°以内,仅2例(2眼)粘连范围在90°～180°之间;术中有4眼在进行房角分离时出现前房积血,对手术无较大影响,术后1 d出血消失。术后有5眼角膜出现不同程度水肿,经对症治疗后均恢复,未见其他并发症。结论急性闭角型青光眼合并白内障采取小切口非超声乳化白内障摘除联合房角分离治疗,能有效提高视力,降低眼压和开放房角,减少术后并发症,具有临床推广价值。
Objective To observe the effect of small incision non-phacoemulsification cataract extraction combined with goniosynechialysis in acute closed-angle glaucoma with cataract.Methods 40 cases(44 eyes) of acute closed-angle glaucoma with cataract who underwent surgery from March 2016 to March 2017 were selected.All patients received small incision non-phacoemulsification cataract extraction combined with goniosynechialysis.Visual acuity recovery after operation and intraocular pressure 3 months after operation were observed.Before operation and 3 months after operation,the changes of central anterior chamber depth were examined by A-ultrasound,and gonioscopy was conducted.The postoperative complications were observed at the same time.Results After surgery,the visual acuity of the patients significantly improved,and there was statistically significant difference while comparing with those before surgery(P<0.001).At 3 months after operation,intraocular pressure decreased significantly,and anterior chamber depth deepened significantly,difference was statistically significant while comparing with those before operation(P<0.001).The results of anterior chamber keratoscopy showed that the anterior chamber angle significantly widened after operation,difference was statistically significant difference while comparing with those before operation(P<0.001).At 3 months after operation,31 cases(33 eyes) had angle open,7 cases(9 eyes) had adhesions within 90°,and only 2 cases(2 eyes) had adhesions ranging from 90° to 180°.Hyphema occurred in 4 eyes during goniosynechialysis,which had no significant effect on the operation,and the hyphema disappeared 1 day after operation.After operation,corneal edema occurred in 5 eyes,which recovered after symptomatic treatment without any other complications.Conclusion Small incision non-phacoemulsification cataract extraction combined with goniosynechialysis in acute closed-angle glaucoma with cataract can remarkably improve visual acuity,reduce intraocular pressure,open angle and postoperative complications,which is worthy of clinical promotion.
作者
谭伟华
凌国华
TAN Weihua;LING Guohua(Department of Ophthalmology,People’s Hospital of Tiandong County,Tiandong 531500,China)
出处
《右江医学》
2019年第2期126-129,共4页
Chinese Youjiang Medical Journal
关键词
白内障
急性闭角型青光眼
房角分离
超声乳化
cataract
acute angle-closure glaucoma
goniosynechialysis
phacoemulsification
作者简介
谭伟华,男,副主任医师。E-mail:GX.TD.TWH@163.com.
