目的：探讨在基层的贫困白内障光明行动中，白内障合并青光眼的患者手术方式的选择及围手术期的处理。方法对2008年至2014年30例(32眼)白内障合并青光眼患者采用了巩膜瓣下隧道式小切口白内障囊外摘除，人工晶体植入联合小梁切除术。术后观察视力、眼压、滤过泡及并发症。结果术后随诊3个月~24个月，视力≥4.8者24只眼(75%)，视力4.2~4.8 者6只眼(18.7%)，视力≤4.2者2只眼(6.3%)。术后眼压<20.55mmHg 为28只眼(87.5%)，眼压20.55~25mmHg 为4只眼(12.5%)，单用噻吗洛尔眼液，眼压得以控制。功能性滤过泡形成28眼(87.5%)。所有手术均无严重并发症发生。结论在防盲中白内障青光眼联合手术切口小，眼压控制好，术后并发症少；且白内障青光眼在一次手术中完成，方便易行，不需要昂贵的设备，让贫困的患者减少了费用开支，值得推广。%Objective To investigate the poor cataract action at the grass-roots level in patients with cataract and glauco-ma operation mode, the selection and treatment of peri operation period. Methods 30 cases of 2008 ~2014 years(32 eyes)with cataract and glaucoma with scleral tunnel small incision extracapsular cataract extraction, intraocular lens implantation combined with trabeculectomy. The visual acuity, intraocular pressure, filtering bleb and complications. Results After 3 months follow-up of ~12 months, visual acuity≥4. 8 in 24 eyes(75%), visual acuity was 4. 2~4. 8 in 6 eyes(18. 7%), the visual acuity of≤4. 2 in 2 eyes(6. 3%). Postoperative intraocular pressure below 20. 55mmHg 28 eyes(87. 5%), intraocular pressure 20. 55~ n 25mmHg 4 eyes(12. 5%), alone of timolol eye drops, intraocular pressure can be controlled. The formation of functional filtering bleb in 28 eyes(87. 5%). All the operation without serious complications. Conclusion In the prevention of blindness in operation with small incision cataract combined with glaucoma, intraocular pressure control, less postoperative complications of cataract and glaucoma, more important is realized in one operation, convenient and simple, don’t need expensive equipment, but also make the impoverished patients reduces expenses.
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