超声乳化治疗早期闭角型青光眼是否联合周边虹膜切除术的研究

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1、超声乳化治疗早期闭角型青光眼是否联合周边虹膜切除术的研究作者：邝国平，刘科峰，冯少颖，李娟，李婷怡，周小平，陈书扬【摘要】　　目的：探讨白内障超声乳化并人工晶状体植入术治疗闭角型青光眼临床前期或先兆期患者术中是否需要联合周边虹膜切除术。方法：40例40眼原发性闭角型青光眼临床前期或先兆期病例，术前随机分成A组（白内障超声乳化+人工晶状体植入）和B组（白内障超声乳化+人工晶状体植入+周边虹膜切除术），对比两组术后视力、眼压、前房深度、Scheie前房角分级进行统计分析。结果：两组病例都未发生黄斑囊样水

2、肿、驱逐性大出血等并发症。1例联合周边虹膜切除的患者出现前房积血，对症治疗后出血吸收。两组病例术后视力较术前提高，术后两组视力、眼压、前房深度、Scheie前房角分级比较差异无显著性。结论：闭角型青光眼临床前期、先兆期采用白内障超声乳化摘除晶状体，可有效预防青光眼的急性发作，并显著提高患者的视力，术中不需要另行周边虹膜切除术。【关键词】白内障超声乳化并人工晶状体植入术；周边虹膜切除术；原发性闭角型青光眼临床前期或先兆期　　AbstractAIM:Toevaluatewhetherornottoco

3、mbineperipheraliridotomywithphacoemulsificationandintraocular8lensimplantationtoremedypatientswithangleclosureglaucomainthepreclinicalandpresymptomaticphases.METHODS:Fortypatients40eyeswithangleclosureglaucomainthepreclinicalandpresymptomaticphaseswe

4、rerandomlydividedintotwogroups:groupA(phacoemulsificationandintraocularlensimplantation)andgroupB(phacoemulsificationandintraocularlensimplantationcombinedwithperipheraliridotomy),tostatisticallyanalyzethepostoperativecorrectedvision,intraocularpressur

5、e,anteriorchamberdepth,gradingoftheanteriorchamberangle(scheie)ofthetwogroups.RESULTS:Noseverecomplicationsoccurredintwogroups,hyphemaoccurredinoneeyeinthegroupB,anditrecoveredaftersymptomatictreatment.Thetwogroupscorrectedvisionwereimprovedpostoperat

6、ivelycomparedwith.preoperative.Therewasnosignificantdiferenceinthepostoperativecorrectedvision,intraocularpressure,anteriorchamberdepth,gradingoftheanteriorchamberangle(scheie)betweengroupAandgroupB.CONCLUSION:Themanagementofangleclosureglaucomainthep

7、reclinicalandpresymptomaticphasesbyphacoemulsificationandintraocularlensimplantationcanpreventitsacuteonsetandimprovethecorrectedvision.Itsnotnecessarytocombineperipheraliridotomywithphacoemulsificationandintraocular8lens.　　KEYWORDS:phacoemulsificati

8、onandintraocularlensimplantation;peripheraliridotomy;angleclosureglaucoma;preclinicalandpresymptomaticphasesofangleclosureglaucoma　　0引言目前公认有效的原发性闭角型青光眼预防性治疗主要有周边虹膜切除术和激光周边虹膜造孔术，通过沟通前后房，防止瞳孔阻滞引起的青光眼急性发作。但由于年龄增加、手术等原因，白内障可加速形成，而必须进行白内障摘