三联手术治疗老年性白内障合并急性闭角型青光眼效果分析.docVIP

三联手术治疗老年性白内障合并急性闭角型青光眼的效果分析 　　[摘要]目的 探讨三联手术（白内障超声乳化联合人工晶状体植入及小梁切除术）治疗老年性白内障合并急性闭角型青光眼的效果及安全性。方法 选取我院2014年9月～2016年5月收治的42例老年性白内障合并急性闭角型青光眼患者，采用三联手术进行治疗。观察患者手术前后视力、眼压、前房深度变化及术后并发症发生情况。结果 患者术后6个月矫正视力≥0.50者15例，矫正视力0.12～0.40者23例，较术前明显改善；手术前后视力情况比较，差异有统计学意义（P0.05）。术后6个月平均眼压稳定在（14.02±8.32）mmHg，显著低于术前的（36.21±7.14）mmHg，差异有统计学意义（P0.05）。术前平均前房深度为（1.82±1.06）mm，术后6个月为（3.52±0.61）mm，差异有统计学意义（P0.05）。术中术后并发症为角膜水肿、一过性眼压升高及前房出血等，无严重并发症发生。结论 三联手术治疗老年性白内障合并急性闭角型青光眼具有创伤性小、视力恢复快、术后并发症少等优点，值得临床推广应用。 　　[关键词]超声乳化；人工晶状体植入；小梁切除术；老年性白内障；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] 1674-4721（2017）02（b）-0093-03 　　[Abstract]Objective To investigate the clinical effects of triple operation （phacoemulsification with intraocular lens implantation and trabeculectomy） in the treatment of senile cataract with acute angle closure glaucoma.Methods 42 patients suffered from senile cataract with acute angle closure glaucoma in our hospital from September 2014 to May 2016 were selected and treated with triple operation.The eyesight，intraocular pressure，vision depth of central anterior chamber and complication were compared before and after operation.Results The visual acuity of 15 patients were ≥0.50 and 23 patients were 0.12～0.40 6 months after operation，which significantly improved compared to with that before operation （P0.05）.The mean intraocular pressure of 6 months after operation was （14.02±8.32） mmHg，which was statistically significantly lower than the [（36.21±7.14） mmHg] before operation （P0.05）.The mean anterior chamber depth was （1.82±1.06） mm before operation，with （3.52±0.61） mm 6 months after operation，and the difference was statistically significant （P0.05）.There were no severe complications following the operation，except that intraoperative and postoperative complications included corneal edema，transient intraocular pressure and anterior chamber hemorrhage.Conclusion Triple operation in the treatment of senile cataract with acute angle closure glaucoma has the advantages of less trauma，fast