CAJ | 학술논문

目的探讨白内障超声乳化联合瞳孔成形术在治疗白内障合并闭角型青光眼急性发作后瞳孔散大的疗效.方法对29例(29只眼)急性发作后瞳孔固定散大的闭角型青光眼白内障病人,行白内障超声乳化术,并在上方透明角膜缘切口或同时在下方角膜缘做切口,采用开放式缝合虹膜组织1～2针修复瞳孔.对比分析术前、术后眼压、瞳孔大小和视功能,随访3月至5年,平均27个月.结果术后眼压为(11.2±3.4)mm Hg,比住院当天眼压(37.3±4.0)mm Hg明显降低,差异显著有统计学意义(t=3.084,P=0.005)；术前瞳孔横径(5.69±0.78 )mm、垂直径(6.12±0.68 )mm,术后横径(3.14±0.26 )mm、垂直径(3.50±0.30 )mm,瞳孔成形后横径及垂直径均较术前有明显缩小,差异具有统计学意义(P＜0.05)；最佳矫正视力比术前明显提高.结论白内障超声乳化术能使此类患者眼压得到有效控制并提高视力,联合瞳孔成形可治疗青光眼急性发作后的瞳孔散大,进一步提高了视觉质量并避免术后复视、眩光感.
목적 탐토백내장초성유화연합동공성형술재치료백내장합병폐각형청광안급성발작후동공산대적료효.방법 대29례(29지안)급성발작후동공고정산대적폐각형청광안백내장병인,행백내장초성유화술,병재상방투명각막연절구혹동시재하방각막연주절구,채용개방식봉합홍막조직1～2침수복동공.대비분석술전、술후안압、동공대소화시공능,수방3월지5년,평균27개월.결과 술후안압위(11.2±3.4)mm Hg,비주원당천안압(37.3±4.0)mm Hg명현강저,차이현저유통계학의의(t=3.084,P=0.005)；술전동공횡경(5.69±0.78 )mm、수직경(6.12±0.68 )mm,술후횡경(3.14±0.26 )mm、수직경(3.50±0.30 )mm,동공성형후횡경급수직경균교술전유명현축소,차이구유통계학의의(P＜0.05)；최가교정시력비술전명현제고.결론 백내장초성유화술능사차류환자안압득도유효공제병제고시력,연합동공성형가치료청광안급성발작후적동공산대,진일보제고료시각질량병피면술후복시、현광감.
Objective To observe the effect of the treatment on cataract and mydriasis after acute angle-closure glaucoma by phacoemulsification and pupil angioplasty.Methods Of 29 patients (29eyes) with cataract and mydriasis after acute angle-closure glaucoma,was given phacoemulsification and pupil angioplasty.The incision was at the up and/or below limbus of the cornea,and the iris with an open suture 1 to 2 pin fixed pupil.Intraocular pressure (IOP),pupil size and visual function were compared both preoperative and postoperative.The patients were followed up for 3 months to 5years,an average of 27 months.Results Postoperative IOP (11.2± 3.4) mmHg reduced significantly than the preoperative IOP (37.3± 4.0) mmHg,the difference was significant (t =3.084,P =0.005).Postoperative pupil diameter was (3.14± 0.26) mm and vertical diameter (3.50t 0.30) mm which was significantly reduced than the preoperative pupil diameter of (5.69± 0.78) mm and vertical diameter (6.12 ± 0.68) mm,the results were statistically significant (P ＜0.05).Best corrected visual acuity significantly improved compared with preoperative.Conclusions Phacoemulsification can effectively control the intraocular pressure in these patients,improve vision,and combine with pupil angioplasty can treat mydriasis after primary acute angle-closure glaucoma,and can further improve the visual quality to prevent postoperative diplopia and glare sense.