CAJ | 학술논문

目的：探讨超声乳化联合小梁切除术治疗老年白内障合并青光眼的疗效，分析其并发症的原因并进行处理。 　　方法：回顾分析本院35例42眼老年白内障合并青光眼手术患者应用超声乳化联合小梁切除术的治疗过程，观察患者手术前后视力、前房深度、眼压变化，并分析其并发症发生情况，然后进行处理。随访时间为6～18 mo。 　　结果：患者术后视力均有不同程度的提高，矫正视力达＜0．1者2眼（5％），0．1～0．3者18眼（43％），＞0．3者22眼（52％）。眼压由术前平均23．24±6．89mmHg，降低为平均16．54±2．56 mmHg。患者术后前房深度均较术前加深，由术前平均1．34±0．41mm增加到术后2．81±0．53mm。并发症发生情况：角膜水肿14眼；纤维素样渗出2眼；前房出血2眼；浅前房、低眼压1眼；后囊混浊2眼；术后高眼压3眼。各并发症经过相应积极的处理后，患者均取得较满意的疗效。 　　结论：超声乳化联合小梁切除术治疗老年白内障合并青光眼具有损伤小、愈合快等优点，是治疗白内障合并青光眼较安全、有效的方法。但是由于青光眼患者眼前节较为狭窄，超声乳化摘除手术存在一定难度，如何有效地处理和预防并发症的发生是手术成功的保证。
목적：탐토초성유화연합소량절제술치료노년백내장합병청광안적료효，분석기병발증적원인병진행처리。 　　방법：회고분석본원35례42안노년백내장합병청광안수술환자응용초성유화연합소량절제술적치료과정，관찰환자수술전후시력、전방심도、안압변화，병분석기병발증발생정황，연후진행처리。수방시간위6～18 mo。 　　결과：환자술후시력균유불동정도적제고，교정시력체＜0．1자2안（5％），0．1～0．3자18안（43％），＞0．3자22안（52％）。안압유술전평균23．24±6．89mmHg，강저위평균16．54±2．56 mmHg。환자술후전방심도균교술전가심，유술전평균1．34±0．41mm증가도술후2．81±0．53mm。병발증발생정황：각막수종14안；섬유소양삼출2안；전방출혈2안；천전방、저안압1안；후낭혼탁2안；술후고안압3안。각병발증경과상응적겁적처리후，환자균취득교만의적료효。 　　결론：초성유화연합소량절제술치료노년백내장합병청광안구유손상소、유합쾌등우점，시치료백내장합병청광안교안전、유효적방법。단시유우청광안환자안전절교위협착，초성유화적제수술존재일정난도，여하유효지처리화예방병발증적발생시수술성공적보증。
? AIM: To investigate efficacy of phacoemulsification combined with trabeculectomy for senile with cataract and glaucoma and to study the cause and the treatment for complications after the surgeries. ? METHODS: This study retrospectively analyzed 35 patients (42 eyes) with cataract and glaucoma treated by phacoemulsification combined with trabeculectomy. Visual acuity, anterior chamber depth, the change of the intraocular pressure( IOP) were observed before and after operations. Postoperative complications were observed and treated too.Follow-ups lasted for 6~18mo. ? RESULTS: Visual acuity of all patients had been improved with different degrees. The best corrected visual acuity (BCVA) was <0.1 in 2 eyes (5%), 0.1~0.3 in 18 eyes (43%) and >0.3 in 22 eyes (52%).The mean IOP reduced from 23.24±6.89 mmHg before operations to 16.54 ±2.56mmHg after operations.Anterior chamber depth increased from 1.34 ±0.41mm to 2.81 ±0.53mmHg after operations.About complications, there were 14 eyes with corneal edema, 2 eyes with fibrinoid exudation, 2 eyes with anterior chamber hemorrhage; 1 eyes with shallow anterior chamber and low intraocular pressure, 2 eyes with posterior capsule opacification, 3 eyes with high IOP.After the treatment for complications, the patients were satisfied with the operation efficacy. ? CONCLUSION: Phacoemulsification combined with trabeculectomy is safe and effective on the treatment of cataract coexisting with glaucoma, making little damage and quick healing.However, due to shallower anterior segment in glaucoma patients, phacoemulsification is difficult to performance.How to avoid the occurrence of complications and to treat them are the guarantee for successful operation.