中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2014年
30期
102-103
,共2页
青光眼%闭角型%白内障
青光眼%閉角型%白內障
청광안%폐각형%백내장
Glaucoma%Goniosynechialysis%Cataract
目的：探讨超声乳化白内障吸除人工晶体植入联合房角分离、虹膜周边切除、小梁切除术治疗急慢性闭角型青光眼合并白内障的疗效。方法：将38例48眼青光眼合并白内障患者根据房角粘连情况分为3组：房角粘连关闭≤180°12眼，采用超乳联合房角分离术；180°＜房角粘连关闭≤270°20眼，采用超乳联合房角分离、虹膜周边切除术；房角粘连关闭＞270°16眼，采用超乳、房角分离联合小梁切除术(简称三联)。随访3个月～5年，对比术前、术后的视力、眼压、前房深度及前房角变化。结果：29眼急性闭角型青光眼和19眼慢性闭角型青光眼术后眼压控制在正常范围，视力恢复良好；6只慢性闭角型青光眼房角粘连＞2/3，术后近期眼压控制好，术后1.8～2年眼压再次增高，药物效果好，眼压控制在正常范围。结论：对于原发性闭角型青光眼合并白内障患者，根据房角关闭情况：房角粘连关闭≤180°，仅行超乳联合房角分离术；180°＜房角粘连关闭＜270°，超乳联合房角分离、虹膜周边切除术；房角粘连关闭＞270°，超乳联合小梁切除术(三联术)可有效控制眼压，但仍需长期随访。
目的：探討超聲乳化白內障吸除人工晶體植入聯閤房角分離、虹膜週邊切除、小樑切除術治療急慢性閉角型青光眼閤併白內障的療效。方法：將38例48眼青光眼閤併白內障患者根據房角粘連情況分為3組：房角粘連關閉≤180°12眼，採用超乳聯閤房角分離術；180°＜房角粘連關閉≤270°20眼，採用超乳聯閤房角分離、虹膜週邊切除術；房角粘連關閉＞270°16眼，採用超乳、房角分離聯閤小樑切除術(簡稱三聯)。隨訪3箇月～5年，對比術前、術後的視力、眼壓、前房深度及前房角變化。結果：29眼急性閉角型青光眼和19眼慢性閉角型青光眼術後眼壓控製在正常範圍，視力恢複良好；6隻慢性閉角型青光眼房角粘連＞2/3，術後近期眼壓控製好，術後1.8～2年眼壓再次增高，藥物效果好，眼壓控製在正常範圍。結論：對于原髮性閉角型青光眼閤併白內障患者，根據房角關閉情況：房角粘連關閉≤180°，僅行超乳聯閤房角分離術；180°＜房角粘連關閉＜270°，超乳聯閤房角分離、虹膜週邊切除術；房角粘連關閉＞270°，超乳聯閤小樑切除術(三聯術)可有效控製眼壓，但仍需長期隨訪。
목적：탐토초성유화백내장흡제인공정체식입연합방각분리、홍막주변절제、소량절제술치료급만성폐각형청광안합병백내장적료효。방법：장38례48안청광안합병백내장환자근거방각점련정황분위3조：방각점련관폐≤180°12안，채용초유연합방각분리술；180°＜방각점련관폐≤270°20안，채용초유연합방각분리、홍막주변절제술；방각점련관폐＞270°16안，채용초유、방각분리연합소량절제술(간칭삼련)。수방3개월～5년，대비술전、술후적시력、안압、전방심도급전방각변화。결과：29안급성폐각형청광안화19안만성폐각형청광안술후안압공제재정상범위，시력회복량호；6지만성폐각형청광안방각점련＞2/3，술후근기안압공제호，술후1.8～2년안압재차증고，약물효과호，안압공제재정상범위。결론：대우원발성폐각형청광안합병백내장환자，근거방각관폐정황：방각점련관폐≤180°，부행초유연합방각분리술；180°＜방각점련관폐＜270°，초유연합방각분리、홍막주변절제술；방각점련관폐＞270°，초유연합소량절제술(삼련술)가유효공제안압，단잉수장기수방。
Objective:To explore the curative effect of phacoemulsification and intraocular lens implantation combined with goniosynechialysis,peripheral iridectomy and trabeculectomy in the treatment of acute and chronic angle closure glaucoma with cataract.Methods:According to the corner adhesion situation,38 glaucoma patients with cataract with 48 eyes were divided into three groups.12 eyes were the corner adhesion close≤180°by using phaco joint corner separation;20 eyse were 180°<the corner adhesion close≤270°by using phaco joint corner separation and peripheral iridectomy;16 eyes were the corner adhesion close>270°by using super milk,goniosynechialysis combined with trabeculectomy(for short trigeminy).Follow up of 3 months to 5 years,the changs of preoperative and postoperative visual acuity,intraocular pressure,anterior chamber depth and anterior chamber angle were compared.Results:The postoperative intraocular pressure of 29 acute angle closure glaucoma and 19 chronic angle closure glaucoma were controled in the normal range,and visual acuity recovered well.The adhesion corners of 6 chronic angle closure glaucoma were more than 2/3,and the postoperative recent intraocular pressure was controled well.After 1.8 to 2 years,the intraocular pressure increased again;the drug effect was good;the intraocular pressure was controled in the normal range. Conclusion:For the patients with primary angle closure glaucoma combined with cataract,according to the corner adhesion situation,the corner adhesion close≤180° only was given phaco joint corner separation;180° <the corner adhesion close≤270°was given phaco joint corner separation and peripheral iridectomy;the corner adhesion close>270°was given the super milk combined with trabeculectomy(triple surgery).That can effectively control the intraocular pressure,but still need long term follow-up.
