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目的 :探讨膨胀期白内障继发青光眼的药物及手术治疗。方法 :筛选膨胀期白内障继发青光眼的病例 2 0例 2 1只眼行人工晶状体植入手术 ,术式为 (1)白内障囊外摘除合并人工晶状体植入 (ECCE +IOL) +虹膜周边切除或节段性虹膜切除 ,(2 )ECCE +IOL +小梁切除术。结果 :(1)术后矫正视力提高者 2 0只眼 (95 2 % ) ,其中 0 3～ 1 0者 16只眼 (76 2 % )。 (2 )眼压 15只眼 (71 4% )正常 ,6只眼 (2 8 6 % )局部用药后正常 ,总有效率 10 0 %。 (3)并发症较高 ,其中后囊破裂 2只眼 (9 5 % )瞳孔区渗出膜 7只眼 (33 3 % )。结论 :(1)膨胀期白内障继发青光眼可用缩瞳剂治疗。 (2 )白内障囊外摘除合并抗青光眼手术的同时植入人工晶状体是恢复视力治疗继发青光眼的有效手段 ,术式首选人工晶状体植入 +虹膜周边切除术。 (3)膨胀期白内障继发青光眼术中术后并发症较普通白内障发生率高 ,故应在膨胀期继发青光眼前早手术。 (4 )膨胀期白内障患者为预防继发青光眼可给予缩瞳剂。
Objective: To investigate the medications and surgical treatment of secondary glaucoma in cataract. Methods: 20 cases of secondary glaucoma with cataract were selected for operation. The patients underwent intraocular lens implantation (1) cataract extraction combined with intraocular lens implantation (ECCE + IOL) or iris excision Segmental iridectomy, (2) ECCE + IOL + trabeculectomy. Results: (1) There were 20 eyes (95 2%) with corrected visual acuity postoperatively, of which 16 eyes (76 2%) were from 0 3 to 10. (2) Intraocular pressure was normal in 15 eyes (71 4%) and normal in 6 eyes (286%). The total effective rate was 100%. (3) The complication was high. The posterior capsule ruptured in 2 eyes (95%) and the pupillary area in 7 eyes (33 3%). Conclusion: (1) cataract secondary to glaucoma in dilated period can be treated with miosis agent. (2) Extracapsular cataract surgery with glaucoma surgery combined with intraocular lens implantation is an effective means of restoring secondary visual acuity in glaucoma. Intraocular lens implantation and peri-iridectomy are preferred. (3) Expansion Cataract secondary glaucoma postoperative complications than the high incidence of cataract, it should be in the expansion period early glaucoma surgery. (4) Expansion cataract patients can be given to prevent secondary glaucoma miosis agent.