国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2014年
2期
282-286
,共5页
青光眼%浅前房%高眼压%玻璃体放液%超声乳化%小梁切除%联合手术
青光眼%淺前房%高眼壓%玻璃體放液%超聲乳化%小樑切除%聯閤手術
청광안%천전방%고안압%파리체방액%초성유화%소량절제%연합수술
glaucoma%shallow anterior chamber%high intraocular pressure%vitreous humour extraction%phacoemulsification%trabeculectomy%combined surgery
目的：探讨玻璃体放液＋白内障超声乳化吸出＋人工晶状体植入＋复合式小梁切除四联手术治疗急性闭角型青光眼持续高眼压的效果及安全性。<br> 方法：回顾分析对我院62例62眼，男26例26眼，女36例36眼，符合诊断急性闭角型青光，前房深度浅Ⅰ-浅Ⅱa级，经最大剂量药物治疗48～72 h后眼压仍＞40 mmHg的患者。根据患者术前视力分为两组，其中33例33眼实施玻璃体放液＋白内障超声乳化吸出＋人工晶状体植入＋复合式小梁切除四联手术治疗（试验组），29例29眼实施前房穿刺放液＋复合式小梁切除两联手术治疗（对照组），术后通过观察视力、眼压、并发症及滤过泡情况等，比较两组患者治疗效果。<br> 结果：所有患者经手术治疗后高眼压均得到控制，术后1wk四联手术组眼压明显低于两联手术组（P＜0．05）。两组观察6 mo，四联术后视力及手术完全成功率明显优于两联手术，在术后并发症及有效滤过泡形成率方面两组无显著差异（P＞0．05）。<br> 结论：极浅前房的急性闭角型青光眼患者在持续高眼压下，玻璃体放液＋白内障超声乳化吸出＋人工晶状体植入＋复合式小梁切除术四联手术及治疗是安全有效的，在持续高眼压状态下，应积极手术治疗，以挽救患者视力。
目的：探討玻璃體放液＋白內障超聲乳化吸齣＋人工晶狀體植入＋複閤式小樑切除四聯手術治療急性閉角型青光眼持續高眼壓的效果及安全性。<br> 方法：迴顧分析對我院62例62眼，男26例26眼，女36例36眼，符閤診斷急性閉角型青光，前房深度淺Ⅰ-淺Ⅱa級，經最大劑量藥物治療48～72 h後眼壓仍＞40 mmHg的患者。根據患者術前視力分為兩組，其中33例33眼實施玻璃體放液＋白內障超聲乳化吸齣＋人工晶狀體植入＋複閤式小樑切除四聯手術治療（試驗組），29例29眼實施前房穿刺放液＋複閤式小樑切除兩聯手術治療（對照組），術後通過觀察視力、眼壓、併髮癥及濾過泡情況等，比較兩組患者治療效果。<br> 結果：所有患者經手術治療後高眼壓均得到控製，術後1wk四聯手術組眼壓明顯低于兩聯手術組（P＜0．05）。兩組觀察6 mo，四聯術後視力及手術完全成功率明顯優于兩聯手術，在術後併髮癥及有效濾過泡形成率方麵兩組無顯著差異（P＞0．05）。<br> 結論：極淺前房的急性閉角型青光眼患者在持續高眼壓下，玻璃體放液＋白內障超聲乳化吸齣＋人工晶狀體植入＋複閤式小樑切除術四聯手術及治療是安全有效的，在持續高眼壓狀態下，應積極手術治療，以輓救患者視力。
목적：탐토파리체방액＋백내장초성유화흡출＋인공정상체식입＋복합식소량절제사련수술치료급성폐각형청광안지속고안압적효과급안전성。<br> 방법：회고분석대아원62례62안，남26례26안，녀36례36안，부합진단급성폐각형청광，전방심도천Ⅰ-천Ⅱa급，경최대제량약물치료48～72 h후안압잉＞40 mmHg적환자。근거환자술전시력분위량조，기중33례33안실시파리체방액＋백내장초성유화흡출＋인공정상체식입＋복합식소량절제사련수술치료（시험조），29례29안실시전방천자방액＋복합식소량절제량련수술치료（대조조），술후통과관찰시력、안압、병발증급려과포정황등，비교량조환자치료효과。<br> 결과：소유환자경수술치료후고안압균득도공제，술후1wk사련수술조안압명현저우량련수술조（P＜0．05）。량조관찰6 mo，사련술후시력급수술완전성공솔명현우우량련수술，재술후병발증급유효려과포형성솔방면량조무현저차이（P＞0．05）。<br> 결론：겁천전방적급성폐각형청광안환자재지속고안압하，파리체방액＋백내장초성유화흡출＋인공정상체식입＋복합식소량절제술사련수술급치료시안전유효적，재지속고안압상태하，응적겁수술치료，이만구환자시력。
AIM:To study the efficacy and safety of the combined four - surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy in managing sustained high intraocular hypertension of acute angle -closure glaucoma. <br> METHODS:Retrospectively analyzed the post-operation result of 62 patients (62 eyes), consisting of 26 males (26 eyes) and 36 females ( 36 eyes) , who were diagnosed as acute angle -closure glaucoma with anterior chamber depth of shallow class-I-IIa.Their IOP were greater than 40mmHg after 48-72h being dosed at the maximum.The patients were divided into two groups with their preoperative visual acuity.The combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy were performed on 33 patients ( 33 eyes ) in the experimental group, while the binary-sugery of anterior chamber paracentesis and compound trabeculectomy was performed on 29 patients (29 eyes) in the control group. Post-operative visual acuity, IOP, complications and filtering bleb were observed to compare the treatment results. <br> RESULTS:The high IOP of all eyes were controlled after surgeries. The IOP of the four -surgery group was obviously lower than the binary-surgery group after 1wk post the surgeries (P<0.05).Both groups were observed for 6mo. Post -operative visual acuity and complete success rate of the four-surgery were distinctly better than the binary-surgery, and no distinct difference was found in complications and filtering bleb occurrence ( P>0.05). <br> CONCLUSION: The combined four-surgery of vitreous humour extraction, phacoemulsification cataract, artificial lens implantation, and compound trabeculectomy is safe and effective in managing acute angle-closure glaucoma with extremely shallow anterior chamber and sustained high IOP.Such surgeries should be actively performed on the patients with sustained high IOP to rescue their visual acuity.
