闭角型青光眼术后并发性白内障微切口超声乳化摘除联合iol植入的临床观察

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1、闭角型青光眼术后并发性白内障微切口超声乳化摘除联合IOL植入的临床观察邓芳祝（郴州市第四人民医院眼科湖南郴州424100）【摘要】R的：探讨闭角型青光眼复合式小梁切除术后并发性障微切门超声乳化摘除联合人工晶状体植入术的临床疗效。方法：对39例（42眼）闭角型青光眼复合式小梁切除术后并发性白内障采取透明角膜1.8mm切门施行超声乳化摘除联合人工晶状体植入术，观察视力，眼压，角膜反应，角膜内皮细胞计数，晶状体囊膜改变，随访观察6m〜12m。结果：术后42眼视力较术前均提高；11眼眼压短暂性升高；39眼前房比术前明显加深，2眼前房稍加深，但仍为浅lib,1眼

2、前房为浅III,需长期使用睫状肌麻痹剂；21眼出现不同程度角膜水肿，经局部皮质类固醇激素眼液滴眼消退，42眼术后3m角膜内皮细胞计数较术前平均减少15.13%，其屮1眼术后8m出现角膜内皮细胞功能失代偿行穿透性角膜移植术；42眼前囊门直径较术屮不同程度缩小，2眼于术后lm出现明显囊袋皱缩综合征，行YAG激光前囊放射状切开术。结论：微切口超声乳化摘除闭角型青光眼小梁切除术后并发性白内障，可减少角膜内皮细胞丢失率，保护滤过泡，大部分患者前房可恢复正常，少数睫状体极度前旋前移患者仍需使用睫状体麻痹剂才能维持前房的稳定，而角膜内皮细胞计数及形态异常的患者，即使

3、采用微切门超声乳化摘除白内障且术屮注意对其保护，但仍可能需行角膜移植术。【关键词】折叠人工晶状体；微切口超声乳化；闭角型青光眼；小梁切除术【中图分类号】R775【文献标识码】A【文章编号】1004-6194（2015）01-0156-02Clinicalobservationofcoaxialmicro-incisionpharoemulsificationwithafoldableintraocularlensimplantationforangle-closureglaucomapatientswithcataractaftertrabeculec

4、tomyDengFang-ZhuDepartmentofophthalmology,People’sfourthhospitalofChenzhouinHuNanProvince,ChenZhou,424100,China【Abstract】Objective：Toinvestigatetheclinicaloutcomesofcoaxialmicro-incisionpharoemulsificationwithafoldableintraocularlensimplantationforangle-closureglaucomapati

5、entswithcataractaftertrabeculectomy.Methods：Forty-twoeyesofthirty-nineangle-closureglaucomapatientswithcataractaftertrabeculectomyreceivedcoaxial1.8mmmicroincisioncataractsurgerywithfoldableintraocularlensimplantation(MI60,Bausch&Lomb).Thefollowingparameterswereevaluatedpreo

6、perativelyandoneday,oneweekandthreemonthsaftersurgery:distancebestcorrectedvisualacuity(BCVA),intraocularpressure,cornealendothelialcellcounts,Andtheresponseofthecornea,anteriorchamberdepth(ACD)andchangeofthelenscapsulemembranewereobservedfor6mto12m.Results：TheBCVAofallpatientsi

7、mproved.Eleveneyeshadtransientelevatedintraocularpressure;Thirty-nineeyeshadobviouslydeeperACD,twoeyeshadonlyalittledeeperACD,andoneeyehadthesameneedinglong-termuseofcycloplegiaagent.Differentdegreeofcornealedemaappearedintwenty-oneeyesanddisappearedafterusingoftopicalcorticoste

8、roidseyedrop.At3mpostoperatively,theendothelial