CAJ | 학술논문

目的通过超声乳化摘除晶状体治疗晶状体半脱位引起的小梁切除术后浅前房或慢性眼压升高.方法回顾性病例研究.小梁切除术后经超声生物显微镜(UBM)确诊为晶状体半脱位患者7例(8眼),行超声乳化晶状体摘除联合囊袋张力环和人工晶状体植入术,比较手术前后的视力、眼压、前房深度,并采用配对t检验进行分析.结果小梁切除术与超声乳化摘除半脱位晶状体间隔(67.4±34.9)d(30～125 d).术前裸眼视力(logMAR)为0.61±0.36,术后1个月裸眼视力为0.16±0.09(t=3.629,P<0.01).术前矫正视力为0.38±0.32,术后1个月为-0.01±0.10 (t=3.629,P＜0.01).术前眼压为(25.45 ±6.92) mmHg,术后1个月为(15.28+0.76) mmHg(t=4.234,P＜0.01),眼压不用药物均得到控制.术前中央前房深度为(1.20±0.36)mm,术后1个月为(2.57±0.38)mm (t=-11.075,P＜0.01).术中发现晶状体脱位范围为(99.38±46.02)°(90°～180°).结论超声乳化晶状体联合囊袋张力环和人工晶状体植入,可以有效缓解晶状体半脱位所致浅前房或慢性眼压升高.
목적 통과초성유화적제정상체치료정상체반탈위인기적소량절제술후천전방혹만성안압승고.방법 회고성병례연구.소량절제술후경초성생물현미경(UBM)학진위정상체반탈위환자7례(8안),행초성유화정상체적제연합낭대장력배화인공정상체식입술,비교수술전후적시력、안압、전방심도,병채용배대t검험진행분석.결과 소량절제술여초성유화적제반탈위정상체간격(67.4±34.9)d(30～125 d).술전라안시력(logMAR)위0.61±0.36,술후1개월라안시력위0.16±0.09(t=3.629,P<0.01).술전교정시력위0.38±0.32,술후1개월위-0.01±0.10 (t=3.629,P＜0.01).술전안압위(25.45 ±6.92) mmHg,술후1개월위(15.28+0.76) mmHg(t=4.234,P＜0.01),안압불용약물균득도공제.술전중앙전방심도위(1.20±0.36)mm,술후1개월위(2.57±0.38)mm (t=-11.075,P＜0.01).술중발현정상체탈위범위위(99.38±46.02)°(90°～180°).결론 초성유화정상체연합낭대장력배화인공정상체식입,가이유효완해정상체반탈위소치천전방혹만성안압승고.
Objective To assess phacoemulsification for treatment of a shallow anterior chamber or chronic elevated intraocular pressure caused by lens subluxation after trabeculectomy.Methods A retrospective analysis was conducted on 7 patients (8 eyes) who underwent phacoemulsification with a capsular tension ring (CTR) and intraocular lens (IOL) implants after trabeculectomy.Lens subluxation was diagnosed by ultrasound biomicroscopy (UBM).Changes in visual acuity,intraocular pressure (IOP) and anterior chamber depth before and after the operation were compared using a paired samples t test.Results Phacoemulsification was performed 67.4±34.9 days (30-125 days)after trabeculectomy.Preoperative uncorrected visual acuity (UCVA) (LogMAR) was 0.61±0.36.Postoperative UCVA was 0.16±0.09 at 1 month,which was much better than preoperative UCVA (t=3.629,P＜0.01).Preoperative best corrected visual acuity (BCVA) was 0.38±0.32 (logMAR).Postoperative BCVA was-0.01±0.10 at 1 month,which was also much better than preoperative BCVA (t=3.898,P＜0.01).Preoperative IOP was 25.45±6.92 mmHg.Postoperative IOP was 15.28±0.76 mmHg at 1 month (t=4.234,P＜0.01).The IOP of all subjects was well controlled without medication.Preoperative central anterior chamber depth was 1.20±0.36 mm.Postoperative central anterior chamber depth was 2.57±0.38 mm at 1 month (t=-11.075,P＜0.01).The extent of lens subluxation was 99.38°±46.02° (90°-180°) found during the operation.Conclusion A shallow anterior chamber or chronic elevated intraocular pressure caused by lens subluxation can be alleviated by phacoemusification with a CTR and IOL implantation.