青光眼术后白内障小瞳孔下超声乳化术的临床研究

摘要

目的：探讨青光眼术后白内障在小瞳孔下超声乳化联合人工晶状体植入术的临床疗效及手术技巧。　　方法：采用超声乳化白内障摘出联合人工晶状体植入术治疗小瞳孔青光眼术后白内障36例36眼,均采用透明角膜切口植入折叠人工晶状体,观察比较手术前后视力、眼压滤过泡及并发症情况,术后随访3 mo。　　结果：术前裸眼视力或最佳矫正视力均≤0.3,术后1wk最佳矫正视力≥0.3者23眼(63.89%),术后3mo随访视力≥0.3者34眼(94.44%),视力<0.3者2眼(5.56%),其中1眼为青光眼术后视神经萎缩,1眼合并糖尿病视网膜病变；眼压控制正常,滤过泡完整,未见严重并发症。　　结论：青光眼术后白内障在小瞳孔下行白内障超声乳化联合人工晶状体植入术手术复杂,手术技巧合理应用仍能取得较好临床效果,影响视力的主要因素是原先存在的视网膜视神经病变。%AIM: To investigate the clinical effects of phacoemulsification and surgical techeniques in small pupil cataract after filtering operation of glaucoma. METHODS: Thirty-six cases ( 36 eyes ) of small pupil cataract after filtering operation of glaucoma were underwent phacoemulsification combined with foldable intraocular lens implantation. Postoperative visual acuity, intraocular pressure filtration bleb and complications were observed. The follow-up time was 3mo. RESULTS: The preoperative uncorrected visual acuity (UCVA) or best-corrected visual acuity ( BCVA) ≤0. 3 were in all patients. Postoperativerly, the UCVA or BCVA≥0. 3 after 1wk and 3mo were achieved in 23 eyes (63.89%) and 34 eyes (94. 44%). BCVA was <0. 3 in 2 eyes ( 5. 56%) including optic nerve atrophy of one eye and diabetic retinopathy of one eye. All patients were kept the level of normal intraocular pressure and completed filtering bleb, there were no serious complications. CONCLUSION: Phacoemulsification in small pupil cataract after filtering operation of glaucoma was complex, and reasonable application of operation skills can still achieve better clinical results. The main factor of affecting the visual acuity is pre-existing retinal optic neuropathy.