临床眼科杂志
臨床眼科雜誌
림상안과잡지
Journal of Clinical Ophthalmology
2015年
5期
407-409
,共3页
超声乳化%23G前部玻璃体切除%白内障%青光眼
超聲乳化%23G前部玻璃體切除%白內障%青光眼
초성유화%23G전부파리체절제%백내장%청광안
Phacoemulsification%23G anterior vitrectomy%Cataract%Glaucoma
目的：探讨应用23G微创单通道前部玻璃体切除后行超声乳化并人工晶状体植入治疗膨胀期白内障继发青光眼的手术特点和效果。方法分析药物治疗3～5 d眼压未能控制正常的29例（29只眼）膨胀期白内障继发青光眼的患者，先行23G微创单通道前部玻璃体切除，然后行超声乳化并人工晶状体植入治疗膨胀期白内障继发青光眼。术后随访6个月至1年，对比术前术后视力、眼压、前房深度和房角开放范围。结果手术均顺利，所有患者均未发生严重并发症，术后最佳矫正视力明显提高26只眼（89．6％），其中0．1～0．8者27只眼，＜0.1者2只眼。术前眼压（35．8～47．5）mmHg，术后眼压（13．5～28．9）mmHg。26只眼术后眼压控制在正常范围，3只眼经药物治疗均可达到正常范围（ P ＜0．01）。术前前房深度平均为（1．193±0．265）mm，术后平均为（3．082±0．345） mm，前房深度较术前明显加深，术前术后对比差异有统计学意义（ P ＜0．01）。所有患者术前狭窄的房角术后均增宽，房角检查见关闭的房角部分开放。结论白内障超声乳化并人工晶状体植入联合23G微创前部玻璃体切除治疗膨胀期白内障继发青光眼更安全、有效。
目的：探討應用23G微創單通道前部玻璃體切除後行超聲乳化併人工晶狀體植入治療膨脹期白內障繼髮青光眼的手術特點和效果。方法分析藥物治療3～5 d眼壓未能控製正常的29例（29隻眼）膨脹期白內障繼髮青光眼的患者，先行23G微創單通道前部玻璃體切除，然後行超聲乳化併人工晶狀體植入治療膨脹期白內障繼髮青光眼。術後隨訪6箇月至1年，對比術前術後視力、眼壓、前房深度和房角開放範圍。結果手術均順利，所有患者均未髮生嚴重併髮癥，術後最佳矯正視力明顯提高26隻眼（89．6％），其中0．1～0．8者27隻眼，＜0.1者2隻眼。術前眼壓（35．8～47．5）mmHg，術後眼壓（13．5～28．9）mmHg。26隻眼術後眼壓控製在正常範圍，3隻眼經藥物治療均可達到正常範圍（ P ＜0．01）。術前前房深度平均為（1．193±0．265）mm，術後平均為（3．082±0．345） mm，前房深度較術前明顯加深，術前術後對比差異有統計學意義（ P ＜0．01）。所有患者術前狹窄的房角術後均增寬，房角檢查見關閉的房角部分開放。結論白內障超聲乳化併人工晶狀體植入聯閤23G微創前部玻璃體切除治療膨脹期白內障繼髮青光眼更安全、有效。
목적：탐토응용23G미창단통도전부파리체절제후행초성유화병인공정상체식입치료팽창기백내장계발청광안적수술특점화효과。방법분석약물치료3～5 d안압미능공제정상적29례（29지안）팽창기백내장계발청광안적환자，선행23G미창단통도전부파리체절제，연후행초성유화병인공정상체식입치료팽창기백내장계발청광안。술후수방6개월지1년，대비술전술후시력、안압、전방심도화방각개방범위。결과수술균순리，소유환자균미발생엄중병발증，술후최가교정시력명현제고26지안（89．6％），기중0．1～0．8자27지안，＜0.1자2지안。술전안압（35．8～47．5）mmHg，술후안압（13．5～28．9）mmHg。26지안술후안압공제재정상범위，3지안경약물치료균가체도정상범위（ P ＜0．01）。술전전방심도평균위（1．193±0．265）mm，술후평균위（3．082±0．345） mm，전방심도교술전명현가심，술전술후대비차이유통계학의의（ P ＜0．01）。소유환자술전협착적방각술후균증관，방각검사견관폐적방각부분개방。결론백내장초성유화병인공정상체식입연합23G미창전부파리체절제치료팽창기백내장계발청광안경안전、유효。
Objective To investigate the clinical efficacy of single channel 23G minimally invasive anterior vitrec-tomy combined with phacoemulsification and foldable lens implantation in the treatment of secondary glaucoma due to intu-mescent cataract.Methods Totally 29 eyes of secondary glaucoma due to intumescent cataract with uncontrolled intraocu-lar pressure ( IOP) after 3 to 5 days of medication treatment were studied.These patients were treated with single channel 23G minimally invasive anterior vitrectomy in order to lower the IOP.Phacoemulsification and foldable intraocular lens im-plantation followed vitrectomy.After 6 months to 1 year, pre-and postoperative visual acuity, anterior chamber depth and angle opening degree were analyzed.Results All surgeries were successfully completed.There was no serious complica-tion observed during and after surgery.Best corrected visual acuity improved in 26 eyes (89.6%):it was 0.1~0.8 in 27 eyes and <0.1 in 2 eyes.IOP was 35.8~47.5 mmHg before the surgery, and reduced to 13.5~28.9 mmHg after the surgery.IOP was controlled within the normal range in 3 eyes by medication ( P <0.01).Anterior chamber depth was 1.193 ±0.265 mm before the surgery, and increased to 3.082 ±0.345 mm after the surgery.This change was significant ( P <0.01).Anterior chamber angle was widened or partially opened in all patients after the surgery.Conclusion Phacoe-mulsification and foldable lens implantation combined with 23G minimally invasive anterior vitrectomy is an effective method to treat secondary glaucoma due to intumescent cataract.
