国际眼科杂志
國際眼科雜誌
국제안과잡지
International Eye Science
2015年
11期
1930-1933
,共4页
青光眼%闭角型%白内障超声乳化术%前房
青光眼%閉角型%白內障超聲乳化術%前房
청광안%폐각형%백내장초성유화술%전방
glaucoma%angle - closure%phacoemulsification%anterior chamber
目的：研究房角关闭≥180°(动态房角镜检)的原发性闭角型青光眼合并白内障患者行白内障超声乳化联合人工晶状体植入联合房角分离术前后房角形态的变化，并评价此手术的疗效。方法：前瞻性系列病例研究。观察2013-01/12在我院行白内障手术的房角关闭≥180°(动态房角镜检)的原发性闭角型青光眼合并白内障患者79例79眼术前、术后1、6 mo的房角形态、眼压、最佳矫正视力的变化情况。术前与术后各时间点前房角开放距离500( AOD500)、小梁网与虹膜间夹角500( TIA500)比较采用配对t检验，术前与术后各时间点房角粘连度、最佳矫正视力均采用Kruskal-Wallis H检验。结果：术后1 mo 58眼无需用药眼压控制正常，术后6 mo 56眼无需用药眼压控制正常。术后1、6 mo与术前相比房角粘连情况、AOD500、TIA500、最佳矫正视力差异均有统计学意义(P<0.05)。术后最佳矫正视力除8眼视神经萎缩无改善，其余最佳矫正视力均有提高。结论：对于单纯性瞳孔阻滞性闭角型青光眼合并白内障患者行白内障超声乳化联合人工晶状体植入联合前房角分离术是安全有效的；对于病史较长、虹膜附着位置靠前的非瞳孔阻滞性及多种机制共存型闭角型青光眼合并白内障患者，则术后可能需要联合药物治疗。
目的：研究房角關閉≥180°(動態房角鏡檢)的原髮性閉角型青光眼閤併白內障患者行白內障超聲乳化聯閤人工晶狀體植入聯閤房角分離術前後房角形態的變化，併評價此手術的療效。方法：前瞻性繫列病例研究。觀察2013-01/12在我院行白內障手術的房角關閉≥180°(動態房角鏡檢)的原髮性閉角型青光眼閤併白內障患者79例79眼術前、術後1、6 mo的房角形態、眼壓、最佳矯正視力的變化情況。術前與術後各時間點前房角開放距離500( AOD500)、小樑網與虹膜間夾角500( TIA500)比較採用配對t檢驗，術前與術後各時間點房角粘連度、最佳矯正視力均採用Kruskal-Wallis H檢驗。結果：術後1 mo 58眼無需用藥眼壓控製正常，術後6 mo 56眼無需用藥眼壓控製正常。術後1、6 mo與術前相比房角粘連情況、AOD500、TIA500、最佳矯正視力差異均有統計學意義(P<0.05)。術後最佳矯正視力除8眼視神經萎縮無改善，其餘最佳矯正視力均有提高。結論：對于單純性瞳孔阻滯性閉角型青光眼閤併白內障患者行白內障超聲乳化聯閤人工晶狀體植入聯閤前房角分離術是安全有效的；對于病史較長、虹膜附著位置靠前的非瞳孔阻滯性及多種機製共存型閉角型青光眼閤併白內障患者，則術後可能需要聯閤藥物治療。
목적：연구방각관폐≥180°(동태방각경검)적원발성폐각형청광안합병백내장환자행백내장초성유화연합인공정상체식입연합방각분리술전후방각형태적변화，병평개차수술적료효。방법：전첨성계렬병례연구。관찰2013-01/12재아원행백내장수술적방각관폐≥180°(동태방각경검)적원발성폐각형청광안합병백내장환자79례79안술전、술후1、6 mo적방각형태、안압、최가교정시력적변화정황。술전여술후각시간점전방각개방거리500( AOD500)、소량망여홍막간협각500( TIA500)비교채용배대t검험，술전여술후각시간점방각점련도、최가교정시력균채용Kruskal-Wallis H검험。결과：술후1 mo 58안무수용약안압공제정상，술후6 mo 56안무수용약안압공제정상。술후1、6 mo여술전상비방각점련정황、AOD500、TIA500、최가교정시력차이균유통계학의의(P<0.05)。술후최가교정시력제8안시신경위축무개선，기여최가교정시력균유제고。결론：대우단순성동공조체성폐각형청광안합병백내장환자행백내장초성유화연합인공정상체식입연합전방각분리술시안전유효적；대우병사교장、홍막부착위치고전적비동공조체성급다충궤제공존형폐각형청광안합병백내장환자，칙술후가능수요연합약물치료。
Abstract?AlM: To study themorphological changes of anterior chamber angle in patients with primary angle-closure glaucoma ( PACG ) and in whom the closed anterior chamber angle was ≥180° ( determined by gonioscopy dynamicly ) before and after phacoemulsification combined with goniosynechialysis and to evaluate the clinical efficacy of this surgry.?METHODS:A prospective case series study. Seventy-nine cases ( 79 eyes ) with cataract were enrolled. They went to our hospital for phacoemulsification and were diagnosed as PACG, in whom the closed anterior chamber angle was ≥180° ( determined by gonioscopy dynamicly ) . They were observed for the changes of anterior chamber angle, intraocular pressure ( lOP ) and the best-corrected visual acuity ( BCVA) pre- and post-operative from January to December in 2013. The angle opening distance 500 ( AOD500 ) and trabecular-iris angle 500 ( TlA500 ) before and after surgeries were analyzed using paired student t-test. The range of goniosynechia and BCVA before and after surgeries were analyzed using Kruskal-Wallis H test.? RESULTS: The lOPs of 58 eyes were normal (≤21mmHg ) without any medications at 1mo after operation, and 56 eyes at 6mo after operation. The range of goniosynechia, AOD500, TlA500 and BCVA before operation had significant difference compared with those at 1 and 6mo after operation(P<0. 05). The BCVA were improved except 8 eyes with optic atrophy.? CONCLUSlON: Phacoemulsification combined with goniosynechialysisis is an effective method for angle closure glaucoma simply caused by pupillary block, coexisted with cataract. The angle closure glaucoma without pupillary block which has long course and the location of peripheral iris is anterior and the closure glaucoma coexisted with cataract caused by several different mechanisms should be treated with medicine management after phacoemulsification combined with goniosynechialysisis.
