超声乳化联合房角分离术治疗合并白内障急性闭角型青光眼.docVIP

超声乳化联合房角分离术治疗合并白内障急性闭角型青光眼 　　【摘要】目的 观察超声乳化联合房角分离术治疗合并白内障的急性闭角型青光眼的效果。方法 回顾分析2007年1月―2010年12月，37例40眼合并白内障的急性闭角型青光眼行角巩膜缘切口晶状体超声乳化吸出术和后房型人工晶体植术联合房角分离术，观察术前，术后视力和眼压，房角及视野。结果 术后随访38眼，最佳矫正视力比术前明显提高，眼压较术前降低，中央前房较术前加深，36眼术后前房角完全开放。结论 超声乳化吸出和后型人工晶体植入联合房角分离术能使合并白内障的急性闭角型青光眼患者眼压降低，房角重新开放和视力提高,避免了第二次手术。 　　【关键词】超声乳化术 房角分离术 急性闭角型青光眼 　　中图分类号：R779.6 文献标识码：A 文章编号：1005-0515（2011）7-028-03 　　Phacoemulsification cataract goniosynechialysis treatment of acute angle-closure glaucoma 　　【Abstract】Objective goniosynechialysis phacoemulsification cataract treatment of acute angle-closure glaucoma. 　　MethodsReview 37 patients with cataract and 40 eyes with acute angle-closure glaucoma angle lens sclera incision phacoemulsification surgery and Posterior chamber intraocular lens implantation surgery combined goniosynechialysis on January 2007 -2010 in December, observing visual acuity and intraocular pressure, angle and perspective before and after the surgery. Result 38 eyes were followed up after the surgery, compared with the preoperative, the patients’ best corrected visual acuity was improved compared with preoperative, and IOP was lower than the preoperative, and central anterior chamber was deeper, and 36 patients’ anterior chamber angle’s were completely open.Conclusion After the phacoemulsification and intraocular lens implantation goniosynechialysis cataract, the patients with acute angle-closure glaucoma ‘s IOP was decreased, angle was re-opened and visual acuity was improved so as to avoid thesecond surgery. 　　【Key words】phacoemulsification goniosynechialysis acute angle-closure glaucoma 　　 　　青光眼是一种常见的致盲性眼病，眼压升高，视乳头和视功能损害是其主要的临床特征。急性闭角型青光眼，在我国是青光眼的一种常见类型，占闭角型青光眼的40%-50%，具有前房浅，晶体增厚，位置靠前等解剖特点，房水流出通道的阻滞导致房水无法循正常的流出通道引流至眼外而造成眼压升高是其病理生理特征，其中晶状体因素在发病中起重要作用，解除晶状体因素的影响可从发病机制上有效阻止闭角型青光眼的发生，对于晶状体混浊但不影响视力的急性闭角型青光眼，以往常行滤过性手术，但术后早期常发生并发症，如浅前房和滤过泡瘢痕化。后期白内障发生或加剧，发生白内障的因素包括年龄、术前已存在的白内障，使用缩瞳剂，手术操作，术后虹膜炎症，长期低眼压浅前房，营养改变等，尤其是术前已存在白内障的青光眼患者，术后白内障进一步发展,需第二次手术。因此，我们采用白内障超声乳化后房型人工晶体植入联合房角分离术治疗合并白内