小切口白内障摘除联合小梁切除术治疗开角型青光眼合并白内障

摘要

AIM: To study the clinical effectiveness of trabeculectomy combined with small incision extracapsular cataract extraction and intraocular lens ( IOL ) implantation for the treatment of primary open angle glaucoma coexisting with cataract. METHODS:A total of 34 eyes of 34 patients with primary open angle glaucoma and cataract had trabeculectomy combined with small incision extracapsular cataract extraction and intraocular lens implantation from January 2011 to January 2013. The postoperative visual acuity, intraocular pressure ( IOP ) , filtering bleb and complications were observed. RESULTS: The follow up duration was 6-24 months. The best corrected visual acuity ( BCVA) was 0.1~<0.3 in 4 eyes ( 12%) and 0.3 ~1.0 in 30 eyes ( 88%).The postoperative IOP was 14.7 ±0.8mmHg at postoperative month 6.The functional filtering blebs were presented in 34 eyes in the first week and 28 eyes after 6 weeks, the filtering blebs were not obvious in 4 eyes, and encapsulated filtering blebs were presented in 2 eyes. Postoperative complications included corneal edema in 12 eyes (35%), fibrous exudates in 5 eyes (15%), shallow anterior chamber in 6 eyes ( 18%) and after cataract in 6 eyes (18%). CONCLUSION: Trabeculectomy combined with small incision extracapsular cataract extraction and IOL implantation are effective as an initial surgical treatment for open angle glaucoma patients coexisting with cataract.%目的：观察小切口白内障囊外摘除、后房型人工晶状体植入联合小梁切除术治疗合并白内障的开角型青光眼的疗效。　　方法：回顾分析2011-01/2013-01在我院住院行小切口白内障囊外摘除、后房型人工晶状体植入联合小梁切除术的34例34眼合并白内障的开角型青光眼的疗效，观察术后矫正视力、眼压、滤过泡及并发症等。　　结果：术后随访6～24mo。术后最佳矫正视力0．1～＜0．3者4眼（12％），0．3～1．0者30眼（88％），术后6mo眼压14．7±0．8mmHg。术后1wk内34眼呈功能性滤过泡，6wk后28眼呈功能滤过泡，4眼滤过泡不明显，2眼滤过泡包裹并需加用1种局部降眼压药。术后并发症主要为角膜水肿12眼（35％），前房纤维素性渗出5眼（15％），浅前房6眼（18％），后发性白内障6眼（18％）。　　结论：小切口白内障囊外摘除、后房型人工晶状体植入联合小梁切除术可有效治疗合并白内障的开角型青光眼。