超声乳化摘除半脱位晶状体治疗小梁切除术后的浅前房

摘要

Objective To assess phacoemulsification for treatment of a shallow anterior chamber or chronic elevated intraocular pressure caused by lens subluxation after trabeculectomy.Methods A retrospective analysis was conducted on 7 patients (8 eyes) who underwent phacoemulsification with a capsular tension ring (CTR) and intraocular lens (IOL) implants after trabeculectomy.Lens subluxation was diagnosed by ultrasound biomicroscopy (UBM).Changes in visual acuity,intraocular pressure (IOP) and anterior chamber depth before and after the operation were compared using a paired samples t test.Results Phacoemulsification was performed 67.4±34.9 days (30-125 days)after trabeculectomy.Preoperative uncorrected visual acuity (UCVA) (LogMAR) was 0.61±0.36.Postoperative UCVA was 0.16±0.09 at 1 month,which was much better than preoperative UCVA (t=3.629,P＜0.01).Preoperative best corrected visual acuity (BCVA) was 0.38±0.32 (logMAR).Postoperative BCVA was-0.01±0.10 at 1 month,which was also much better than preoperative BCVA (t=3.898,P＜0.01).Preoperative IOP was 25.45±6.92 mmHg.Postoperative IOP was 15.28±0.76 mmHg at 1 month (t=4.234,P＜0.01).The IOP of all subjects was well controlled without medication.Preoperative central anterior chamber depth was 1.20±0.36 mm.Postoperative central anterior chamber depth was 2.57±0.38 mm at 1 month (t=-11.075,P＜0.01).The extent of lens subluxation was 99.38°±46.02° (90°-180°) found during the operation.Conclusion A shallow anterior chamber or chronic elevated intraocular pressure caused by lens subluxation can be alleviated by phacoemusification with a CTR and IOL implantation.%目的 通过超声乳化摘除晶状体治疗晶状体半脱位引起的小梁切除术后浅前房或慢性眼压升高.方法 回顾性病例研究.小梁切除术后经超声生物显微镜(UBM)确诊为晶状体半脱位患者7例(8眼),行超声乳化晶状体摘除联合囊袋张力环和人工晶状体植入术,比较手术前后的视力、眼压、前房深度,并采用配对t检验进行分析.结果 小梁切除术与超声乳化摘除半脱位晶状体间隔(67.4±34.9)d(30～125 d).术前裸眼视力(logMAR)为0.61±0.36,术后1个月裸眼视力为0.16±0.09(t=3.629,P<0.01).术前矫正视力为0.38±0.32,术后1个月为-0.01±0.10 (t=3.629,P＜0.01).术前眼压为(25.45 ±6.92) mmHg,术后1个月为(15.28+0.76) mmHg(t=4.234,P＜0.01),眼压不用药物均得到控制.术前中央前房深度为(1.20±0.36)mm,术后1个月为(2.57±0.38)mm (t=-11.075,P＜0.01).术中发现晶状体脱位范围为(99.38±46.02)°(90°～180°).结论 超声乳化晶状体联合囊袋张力环和人工晶状体植入,可以有效缓解晶状体半脱位所致浅前房或慢性眼压升高.