CAJ | 학술논문

目的探讨超声乳化白内障治疗闭角型青光眼的适应证及临床效果.方法选择:(1)≥50岁发病者;(2)单用缩瞳剂和(或)单用甘露醇或缩瞳剂联合甘露醇可在1～3d内迅速控制眼压15mmHg以下者;(3)房角镜检查房角开放>1/2;(4)最佳矫正视力<0.5;(5)晶体混浊者作为对象;(6)急性发作者眼压控制在15mmHg以下3～5d,慢性者眼压控制在15mmHg以下2～3d,行常规白内障超声乳化手术.结果术后随访6～18个月.128例152只眼术后最佳矫正视力均有不同程度提高,前房深度明显加深,房角增宽,其中48只眼房角完全开放;64只眼大于3/4周小于全周开放;38只眼大于1/2小于3/4周开放;1例2只眼1/2周开放.除1例2只眼术后,用匹罗卡品联合噻吗心安眼液眼压控制在15～20mmHg,其他病人眼压均在21mmHg以下.手术前后前平均眼压、前房深度,经检验(t=8.75,P<0.001;t=9.15,P<0.001),结果有显著差异.结论恰当适应证的选择可使单纯超声乳化白内障治疗闭角型青光眼获得满意的临床效果.
목적 탐토초성유화백내장치료폐각형청광안적괄응증급림상효과.방법 선택:(1)≥50세발병자;(2)단용축동제화(혹)단용감로순혹축동제연합감로순가재1～3d내신속공제안압15mmHg이하자;(3)방각경검사방각개방>1/2;(4)최가교정시력<0.5;(5)정체혼탁자작위대상;(6)급성발작자안압공제재15mmHg이하3～5d,만성자안압공제재15mmHg이하2～3d,행상규백내장초성유화수술.결과 술후수방6～18개월.128례152지안술후최가교정시력균유불동정도제고,전방심도명현가심,방각증관,기중48지안방각완전개방;64지안대우3/4주소우전주개방;38지안대우1/2소우3/4주개방;1례2지안1/2주개방.제1례2지안술후,용필라잡품연합새마심안안액안압공제재15～20mmHg,기타병인안압균재21mmHg이하.수술전후전평균안압、전방심도,경검험(t=8.75,P<0.001;t=9.15,P<0.001),결과유현저차이.결론 흡당괄응증적선택가사단순초성유화백내장치료폐각형청광안획득만의적림상효과.
Objective To evaluate the indication and effect of phacoemulsification for cataract extrac-tion in the treatment of angle-closure glaucoma.Methods One hundred and twenty eight patients were selected as the follows(152 eyes)(1)over 50 years old;(2)whose intraocular pressure can be controlled below 15mmHg in 1～3 days with the therapy of miotic, mannitol or miotic-mannitol alliance;(3)whose chamber an-gle opened exceed 1/2 of the whole;(4)whose maximum corrected vision was less than 0.5;(5)whose lens was cloudy;(6)whose intra-ocular pressure was controled below 15mmHg after 3～5 days for patients of acute episode and after 2-3 days for patients of chronicity.Results The follow-up period was 6 to 18 months.For all the patients, the maximum corrected vision improved and anterior chamber depth deepened and chamber angle widened.Chamber angle of 48 eyes opened completely;chamber angle of 64 eyes opened exceed 3/4 of the whole;chamber angle of 38 eyes opened 1/2 to 3/4 of the whole;chamber angle of 1 case of 2 eyes opened 1/2 of the whole.Intraocular pressures for 127 patients of 150 eyes were controlled to normal level,exccpt that 1 case of 2 eyes were controlled within 15～20 mmHg after the therapy of pilocarpine and timolol.By applying paired t-analysis, the intmocular pressure and anterior chamber depth in the perioperatively were significance(t =8.75, P<0.001 ; t=9.15, P<0.001).Conclusion With the proper selection of indications, the clinic effect of phacoemulsification for cataract extraction in the treatment of angle-closure glaucoma was satisfactory.