CAJ | 학술논문

目的：探讨单穿刺双切口青光眼白内障联合手术的方法和效果。 　　方法：对28例30眼青光眼合并白内障患者行改良的单穿刺双切口青光眼白内障联合手术。常规白内障超声乳化手术(10∶00位透明角膜切口)后,11∶00~1∶00位距角膜缘后2mm处剪开球结膜及Tenon囊,3mm穿刺刀于角膜缘后2 mm穿刺入前房,作一3 mm宽、1/3~1/4巩膜厚度的巩膜隧道,伸入小梁咬切器,咬除3块约1mm×1mm大小小梁组织。术后随访3~6 mo观察视力、眼压、滤过泡形态( OCT检测)及并发症的情况。 　　结果：术后1wk,视力<0.1者3眼,0.1~者6眼,0.3~者13眼,0.6~0.8者8眼；1眼发生恶性青光眼,8眼早期角膜水肿及瞳孔区轻微纤维素渗出；30眼均为功能性滤过泡(Ⅰ型、Ⅱ型滤过泡), OCT显示滤过口通畅；随访3~6mo,28眼眼压在正常范围内,2眼出现眼压控制不良。结论：单穿刺双切口青光眼白内障联合手术简单易行,手术效果良好,术后并发症少,值得推广。
목적：탐토단천자쌍절구청광안백내장연합수술적방법화효과。 　　방법：대28례30안청광안합병백내장환자행개량적단천자쌍절구청광안백내장연합수술。상규백내장초성유화수술(10∶00위투명각막절구)후,11∶00~1∶00위거각막연후2mm처전개구결막급Tenon낭,3mm천자도우각막연후2 mm천자입전방,작일3 mm관、1/3~1/4공막후도적공막수도,신입소량교절기,교제3괴약1mm×1mm대소소량조직。술후수방3~6 mo관찰시력、안압、려과포형태( OCT검측)급병발증적정황。 　　결과：술후1wk,시력<0.1자3안,0.1~자6안,0.3~자13안,0.6~0.8자8안；1안발생악성청광안,8안조기각막수종급동공구경미섬유소삼출；30안균위공능성려과포(Ⅰ형、Ⅱ형려과포), OCT현시려과구통창；수방3~6mo,28안안압재정상범위내,2안출현안압공제불량。결론：단천자쌍절구청광안백내장연합수술간단역행,수술효과량호,술후병발증소,치득추엄。
AlM:To observe the effects of double incision combined surgery of single - stab trabeculectomy and phacoemulsification. METHODS: Totally 28 cases ( 30 eyes ) with glaucoma and cataract undertook the modified combined surgery of single - stab trabeculectomy and phacoemulsification. After traditional phacoemulsification, cut the bulbar conjunctiva and Tenons capsule from the 11 o'clock to 1 o'clock, then puncture into the anterior chamber in 2mm behind the corneal limbus with 3mm tunnel knife, shaping a 3mm wide, 1/3-1/4 thickness scleral tunnel. Getting into the trabecular tunnel, bite off 3 pieces of trabecular tissue about 1mm × 1mm size. The changes in the imtraocular pressure ( lOP ) and the visual acuity before and after the surgery as well as filtering bleb ( OCT confirmed) and complications were carefully observed in 3-6mo postoperatively. RESULTS: The postoperative visual acuity in 1wk postoperatively less than 0. 1 was found in 3 eyes, from 0. 1 to 0. 3 was found in 6 eyes,from 0. 3 to 0. 6 in 13 eyes, from 0. 6 to 0. 8 in 8 eyes. One eye had malignant glaucoma, and 8 eyes had cornea edema and slightly fibrin exudation in the pupil area; ln all cases maintained function conjunctival blebs of filtering, OCT confirmed this. lOP remained normal in 28 eyes in 3-6mo follow up, lOP of 2 other eyes could be controlled by anti-glaucoma eye drops. CONCLUSlON:Double incision combined surgery of single- stab trabeculectomy and phacoemulsification is effective and safe, reduces the postoperative complications and is worthy of promotion.