中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2010年
8期
867-870
,共4页
罗莉霞%毛真%钟毅敏%程冰%刘杏
囉莉霞%毛真%鐘毅敏%程冰%劉杏
라리하%모진%종의민%정빙%류행
晶状体异位%急性闭角型青光眼%超声乳化白内障吸除术%囊袋张力环%小梁切除术
晶狀體異位%急性閉角型青光眼%超聲乳化白內障吸除術%囊袋張力環%小樑切除術
정상체이위%급성폐각형청광안%초성유화백내장흡제술%낭대장력배%소량절제술
Lens subluxation%Acute angle-closure glaucoma%Phacoemulsification%Capsular tension ring%Trabeculectomy
目的 回顾性分析晶状体异位继发急性闭角型青光眼手术方式的选择及观察其疗效.方法 取36例(41只眼)晶状体异位继发急性闭角型青光眼患者,采用超声生物显微镜观察晶状体悬韧带离断范围,根据晶状体脱位范围以及房角关闭范围,分别选择小梁切除术,超声乳化白内障吸除联合囊袋张力环及人工晶状体植入手术和(或)小梁切除联合超声乳化白内障吸除术,术后随访1个月,观察手术治疗效果.结果 随访期间,患者术后矫正视力提高,眼压降低:术后1d,17只眼(41.46%)矫正视力>0.5;30只眼(73.17%)眼压在21mmHg以内;术后7d,24只眼(58.54%)矫正视力>0.5;35只眼(85.36%)眼压在21mmHg以内;术后30d,27只眼(65.85%)矫正视力>0.5;所有患者眼压在21mmHg以内.结论 在晶状体异位继发急性闭角型青光眼患者中,晶状体脱位范围在1~2个象限者,超声乳化白内障吸除联合囊袋张力环及人工晶状体植入手术是一种安全有效的术式;脱位范围大于2个象限者,选择白内障囊外摘除手术;房角关闭大于1/2的患者,选择小梁切除联合白内障手术.
目的 迴顧性分析晶狀體異位繼髮急性閉角型青光眼手術方式的選擇及觀察其療效.方法 取36例(41隻眼)晶狀體異位繼髮急性閉角型青光眼患者,採用超聲生物顯微鏡觀察晶狀體懸韌帶離斷範圍,根據晶狀體脫位範圍以及房角關閉範圍,分彆選擇小樑切除術,超聲乳化白內障吸除聯閤囊袋張力環及人工晶狀體植入手術和(或)小樑切除聯閤超聲乳化白內障吸除術,術後隨訪1箇月,觀察手術治療效果.結果 隨訪期間,患者術後矯正視力提高,眼壓降低:術後1d,17隻眼(41.46%)矯正視力>0.5;30隻眼(73.17%)眼壓在21mmHg以內;術後7d,24隻眼(58.54%)矯正視力>0.5;35隻眼(85.36%)眼壓在21mmHg以內;術後30d,27隻眼(65.85%)矯正視力>0.5;所有患者眼壓在21mmHg以內.結論 在晶狀體異位繼髮急性閉角型青光眼患者中,晶狀體脫位範圍在1~2箇象限者,超聲乳化白內障吸除聯閤囊袋張力環及人工晶狀體植入手術是一種安全有效的術式;脫位範圍大于2箇象限者,選擇白內障囊外摘除手術;房角關閉大于1/2的患者,選擇小樑切除聯閤白內障手術.
목적 회고성분석정상체이위계발급성폐각형청광안수술방식적선택급관찰기료효.방법 취36례(41지안)정상체이위계발급성폐각형청광안환자,채용초성생물현미경관찰정상체현인대리단범위,근거정상체탈위범위이급방각관폐범위,분별선택소량절제술,초성유화백내장흡제연합낭대장력배급인공정상체식입수술화(혹)소량절제연합초성유화백내장흡제술,술후수방1개월,관찰수술치료효과.결과 수방기간,환자술후교정시력제고,안압강저:술후1d,17지안(41.46%)교정시력>0.5;30지안(73.17%)안압재21mmHg이내;술후7d,24지안(58.54%)교정시력>0.5;35지안(85.36%)안압재21mmHg이내;술후30d,27지안(65.85%)교정시력>0.5;소유환자안압재21mmHg이내.결론 재정상체이위계발급성폐각형청광안환자중,정상체탈위범위재1~2개상한자,초성유화백내장흡제연합낭대장력배급인공정상체식입수술시일충안전유효적술식;탈위범위대우2개상한자,선택백내장낭외적제수술;방각관폐대우1/2적환자,선택소량절제연합백내장수술.
Objective To retrospectively evaluate the surgical procedures and results for eyes with acute angle-closure glaucoma secondary to lens subluxation. Methods Thirty-six cases (41 eyes) with acute angle-closure glaucoma secondary to lens subluxation were examined by gonioscopy and/or ultrasound biomicroscopy (UBM). The different surgical procedures such as phacoemulsification with capsular tension ring lens (CTR) and intraocular lens (IOL) implantation, extracapsular cataract extraction (ECCE) and/or antiglaucoma surgery were chosen according to the extent of anterior chamber angle close and lens subluxation. Visual outcome and intraocular pressure (IOP) were examined on postoperative days 1, 7 and 30. Results The best corrected visual acuity (BCVA) was significantly improved and IOP was well controlled in all eyes during the follow-up. The BCVA was better than 0.5 in 17 eyes (41.46%), in 24 eyes (58.54%) and in 27 eyes (65.85%) on postoperative day 1, 7 and 30, respectively. IOP was less than 21 mmHg in 30 eyes (73.17%), in 35 eyes (85.36%) and in all eyes (100%) on postoperative day 1, 7 and 30, respectively. Conclusions It is safe and effective to choose phacoemulsification combined with CTR and IOL implantation for eyes with zonular defect less than 2 quadrants, ECCE and IOL implantation for eyes with zonular defects more than 2 quadrants and lens extraction combined with trabeculectomy for eyes with anterior chamber angle close more than half of the angle.