【摘要】 目的探讨白内障膨胀期继发青光眼的治疗方法。方法回顾性分析42例42眼白内障膨胀期继发青光眼患者的临床资料,其中32眼行白内障摘出人工晶状体植入术(两联术);9眼行白内障摘出人工晶状体植入联合小梁切除术(三联术);1眼行白内障摘出联合小梁切除术。随访6～12个月,观察裸眼视力及矫正视力,测量眼压;术后3个月测量前房深度并检查房角情况。结果术后39眼(92.9%)在不用任何药物治疗的情况下,眼压完全控制;3眼(7.1%)加用局部降眼压药物治疗后眼压降至正常。40眼术后矫正视力不同程度提高(95.2%);37眼矫正视力≥0.3,其中0.3～0.5者19眼(45.2%),0.6～0.8者15眼(35.7%),1.0者3眼(7.1%)。与术前眼压控制后的视力相比,差异有显著统计学意义(H=11.32,P=0.002)。前房深度由术前的(1.27±0.42)mm增加至(2.48±0.43)mm(t=4.79,P=0.008),房角也重新开放或部分开放增宽(H=5.21,P=0·02)。结论白内障膨胀期继发青光眼,根据药物治疗后眼压控制情况及房角检查结果选择二联或三联术,可以有效地控制眼压、提高视力。更多还原

【Abstract】 Objective To discuss the methods of treating secondary glaucoma due to intumescent cataract.Methods The clinical data of 42 cases(42 eyes)of secondary glaucoma due to intumescent cataract were retrospectively analyzed of them,32 eyes were performed with extracapsular cataract extraction(ECCE)and IOL implantation(two-manner operation),only 9 eyes with ECCE+IOL and comebined with trabeculectomy(three-manner operation),the other one with ECCE and trabeculectomy.All the cases were followed-up for 6 to 12 months.The postoperative intraocular pressure was measured and the corrected visual acuity were observed.The depth of anterior chamber and the chamber angle were checked at the third month postoperation.Results The postoperative intraocular pressure of 39 eyes(92.9%)was complete controlled without any drugs in treatment,and 3 eyes(7.1%)were controlled with local drug therapy.The postoperative corrected visual acuity in 40 eyes(95.2%)improved in different level.Of them,vision was from 0.3 to 0.5 in 19 eyes(45.2%),from 0.6 to 0.8 in 15 eyes(35.7%),1.0 in 3 eyes(7.1%).There is a significant difference between the postoperative vision and the preoperative vision that the intraocular pressure had been controlled before operation(H=11.32,P=0.002).The depth of anterior chamber changed from(1.27±0.42)mm preoperatively to(2.48±0.43)mm postoperatively(t=4.79,P=0.008).After operation all cases’ chamber angle reopened or some part of chamber angle became wide(H=5.21,P=0.02).Conclusion For the secondary glaucoma due to intumescent cataract,the two-or three-manner operation according to the control condition of intraocular pressure after medical treatment and combined with the test results of gonioscopies can effectively control intraocular pressure and improve vision.更多还原