抗青光眼手术后并发性白内障超声乳化手术与临床研究.docVIP

抗青光眼手术后并发性白内障超声乳化手术的临床研究 刘鹏程 邹海东 【摘要】 目的 探讨小切口白内障超声乳化术治疗抗青光眼手术后并发性白内障的临床效果。方法 回顾性病例研究。对2012年1月至2012年6月间上海市一院既往抗青光眼后并发白内障病例52例58眼，平均68.6岁，手术方法为3mm角膜切口白内障超声乳化吸除联合折叠式人工晶体植入术，记录手术超声乳化时间和超声乳化能量，观察前房稳定性、术后角膜及切口情况，房水闪辉。观察术后第1天、第1周和第1个月的视力及角膜散光变化。结果58眼手术平均超声乳化时间为(0.46±0．36)分钟，术后矫正视力≥0.5者，在术后第1天为31眼(53.4%)，第1周时为42眼（72.4%），到了术后三个月时升高到了47眼（81.0%）。结论 小切口超声乳化吸除术可以有效治疗抗青光眼手术后的白内障手术患者，术后效果好，并发症少，对眼压影响很小，术后视力提高明显。 【关键词】 抗青光眼手术 并发性白内障 超声乳化 治疗效果 【Abstract】 Objective：To explore the clinical results of small-incision phacoemulsification on complicated cataract after anti-glaucoma operation. Methods：The trail was retrospectively case study. 52 patients（58eyes）with complicated cataract after anti-glaucoma operation were underwent 3.0mm corneal incision cataract phacoemulsification and foldable intraocular lens implantation in Shanghai First People?s Hospital from 2012 Jan to 2012 Jun,the average age of patients is 68.6.The time and energy of phacoemulsification were recored.And the stability of anterior chamber,corneal incision,aqueous flare, visual acuity,corneal astigmatism were analyzed at 1 day,1 week and 1 month after surgery.Results:The average phacoemulsification time of 58eyes was 0.46±0.36 min.The numbers of patients having corrected visual acuity ≥0.5 were 31eyes(53.4%) at 1 day after surgery,42eyes(72.4%) at 1 week after surgery, 47eyes(81.0%) at 1 month after surgery. Conclusions: Small-incision phacoemulsification is an effective way on complicated cataract after anti-glaucoma operation,with stable curative effect,fewer complications and less influence on intraocular pressure. 【Key Words】anti-glaucoma operation, complicated cataract, phacoemulsification, curative effect 滤过性手术是目前青光眼治疗的常规术式，手术后一般可以达到良好的眼压控制效果。但手术后晶状体加速混浊，继发白内障的病例却常常发生，且往往较严重。如果对这些病例行白内障手术，角膜内皮功能下降、滤过泡、浅前房、虹膜萎缩、瞳孔固定或小瞳孔，晶体囊膜变性，以及晶体核硬度大等因素都增加了手术的难度，继而引起术后并发症相对高发，影响了手术效果。近几年来随着超声能量释放模式、液流管理系统以及人工晶状体设计的突破，超声乳化白内障吸除手术正日臻完美，切口更小，损伤更少，散光更轻，手术更快，视力恢复更佳。本文报道52例58眼曾接受抗青光眼小梁切除术联合虹膜周边切除术，2012年1月至6月间在