CAJ | 학술논문

目的探讨白内障继发青光眼持续高眼压状态下进行晶状体超声乳化手术的手术特点及效果.方法药物治疗3～7d后眼压未能控制的膨胀期白内障继发急性闭角型青光眼26例(26只眼),局麻下先行玻璃体腔穿刺抽液降低眼压,然后实行透明角膜切口晶状体超声乳化联合折叠人工晶状体植入手术.术后随访3个月～3年,对比术前术后视力、眼压、前房深度和前房角开放范围.结果术中、术后均未发生严重手术并发症.术后最佳矫正视力明显好于术前(x2=48.148,P＜0.00l)；眼压较术前明显下降(t=14.2629,P＜0.001)；前房深度加深,术前术后差异有统计学意义(t =20.4744,P＜0.001).所有患者原狭窄的前房角增宽,关闭的前房角部分开放.结论膨胀期白内障继发急性闭角型青光眼持续高眼压状态下的晶状体超声乳化手术是安全有效的.
목적 탐토백내장계발청광안지속고안압상태하진행정상체초성유화수술적수술특점급효과.방법 약물치료3～7d후안압미능공제적팽창기백내장계발급성폐각형청광안26례(26지안),국마하선행파리체강천자추액강저안압,연후실행투명각막절구정상체초성유화연합절첩인공정상체식입수술.술후수방3개월～3년,대비술전술후시력、안압、전방심도화전방각개방범위.결과 술중、술후균미발생엄중수술병발증.술후최가교정시력명현호우술전(x2=48.148,P＜0.00l)；안압교술전명현하강(t=14.2629,P＜0.001)；전방심도가심,술전술후차이유통계학의의(t =20.4744,P＜0.001).소유환자원협착적전방각증관,관폐적전방각부분개방.결론 팽창기백내장계발급성폐각형청광안지속고안압상태하적정상체초성유화수술시안전유효적.
Objective To investigate the efficacy and safety of phacoemulsification for secondary glaucoma following cataract with sustained high intraocular pressure(IOP).Methods 26 eyes of 26 cases of secondary glaucoma to intumescent cataract that the IOP was uncontrolled by drug treatment for 3 to 7 days were studied.Under local anaesthesia,the eyes were treated by aspiration of vitreous in order to lower the IOP,and then phacoemulsification combined with implantation of foldable intraocular lens through transparent cornea incision.After 3 months to 3 years,the visual acuity,IOP,anterior chamber depth and angle opening degree were analyzed pre-and postoperatively.Results There was no serious complication observed in all cases during surgery and postoperatively.Compared with postoperation,the best corrected visual acuity was obviously better than preoperation (p ＜ 0.001) ; the IOP level was decreased significantly (p ＜0.001) ; the anterior chamber depth was increased (p ＜ 0.001).The narrow anterior chamber angle was widened in all cases,and some closed anterior chamber angle could open.Conclusion The surgery of phacoemulsification is safe and effective for acute angle-closure glaucoma following intumescent cataract with persistent high IOP.In order to avoid further damage of visual function,surgery should be performed for these patients with persistent high IOP actively.