摘要
目的 探讨白内障超声乳化联合瞳孔成形术在治疗白内障合并闭角型青光眼急性发作后瞳孔散大的疗效。方法对29例（29只眼）急性发作后瞳孔固定散大的闭角型青光眼白内障病人，行白内障超声乳化术，并在上方透明角膜缘切口或同时在下方角膜缘做切口，采用开放式缝合虹膜组织1～2针修复瞳孔。对比分析术前、术后眼压、瞳孔大小和视功能，随访3月至5年，平均27个月。结果术后眼压为（11．2±3．4）mmHg，比住院当天眼压（37．3±4．0）mmHg明显降低，差异显著有统计学意义（t=3．084，P=0．005）；术前瞳孔横径（5．69±0．78）mm、垂直径（6．12±0．68）mm，术后横径（3．14±0．26）mm、垂直径（3．50±0．30）mm，瞳孔成形后横径及垂直径均较术前有明显缩小，差异具有统计学意义（P〈0．05）；最佳矫正视力比术前明显提高。结论白内障超声乳化术能使此类患者眼压得到有效控制并提高视力，联合瞳孔成形可治疗青光眼急性发作后的瞳孔散大．进一步提高了视觉质量并擗负术后复视、眩光臆．
Objective To observe the effect of the treatment on cataract and mydriasis after acute angle-closure glaucoma by phacoemulsification and pupil angioplasty. Methods Of 29 patients （29 eyes） with cataract and mydriasis after acute angle-closure glaucoma, was given phacoemulsification and pupil angioplasty. The incision was at the up and/or below limbus of the cornea, and the iris with an open suture 1 to 2 pin fixed pupil. Intraocular pressure （IOP）, pupil size and visual function were compared both preoperative and postoperative. The patients were followed up for 3 months to 5 years, an average of 27 months. Results Postoperative IOP （11.2± 3.4） mmHg reduced significantly than the preoperative IOP （37.3 ± 4.0） mmHg, the difference was significant （t =3.084, P =0.005）. Postoperative pupil diameter was （3.14±0.26） mm and vertical diameter （3.50± 0.30） mm which was significantly reduced than the preoperative pupil diameter of （5.69± 0.78） mm and vertical diameter （6.12 ±0.68） mm, the results were statistically significant （P 〈0.05）. Best corrected visual acuity significantly improved compared with preoperative. Conclusions Phacoemulsification can effectively control the intraocular pressure in these patients, improve vision, and combine with pupil angioplasty can treat mydriasis after primary acute angle-closure glaucoma, and can further improve the visual quality to prevent postoperative diplopia and glare sense.
出处
《中国实用眼科杂志》
CSCD
北大核心
2011年第12期1269-1271,共3页
Chinese Journal of Practical Ophthalmology
