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目的:观察超声乳化白内障吸出术联合人工晶状体(IOL)植入治疗激光周边虹膜切除术后闭角型青光眼的治疗效果。方法:激光周边虹膜切除术后闭角型青光眼并白内障患者39例(39眼),被分为两组,Ⅰ组须用抗青光眼药控制眼压,Ⅱ组不须用抗青光眼药控制眼压,患者均行超声乳化白内障吸出和折叠式人工晶状体植入术,术后随访3mo。结果:两组术后最佳矫正视力均较术前显著提高(P<0.05)。术后3moⅠ组眼压为15.72±3.02mmHg,Ⅱ组为16.30±3.81mmHg,两组眼压均比术前明显下降,有显著性差别(P<0.05)。Ⅰ组中央前房深度由术前1.64±0.45mm加深至术后3mo的3.21±0.41mm,Ⅱ组中央前房深度由术前1.92±0.52mm加深至术后3mo的3.18±0.39mm,两组术后中央前房深度均比术前明显加深,有显著性差异(P<0.05),前房角明显增宽。结论:超声乳化白内障吸出和人工晶状体(IOL)植入术不仅能提高激光周边虹膜切除术后青光眼视力,而且可彻底解除闭角型青光眼的瞳孔阻滞。
Objective: To observe the therapeutic effect of phacoemulsification combined with intraocular lens (IOL) implantation on angle-closure glaucoma after laser iridotomy. Methods: 39 patients (39 eyes) with angle-closure glaucoma and cataract after laser iridotomy were divided into two groups. Group I was given anti-glaucoma drug to control intraocular pressure, while group II did not need anti-glaucoma drug to control intraocular pressure , Patients underwent phacoemulsification cataract extraction and foldable intraocular lens implantation, postoperative follow-up 3mo. Results: The best corrected visual acuity after operation in both groups was significantly higher than that before operation (P <0.05). The intraocular pressure was 15.72 ± 3.02mmHg in group I at 3 months postoperatively, and 16.30 ± 3.81mmHg in group Ⅱ. The intraocular pressure of both groups was significantly lower than that before operation (P <0.05). The depth of central anterior chamber in group Ⅰ was deepened from 1.64 ± 0.45mm preoperatively to 3.21 ± 0.41mm at 3mo postoperatively. The depth of central anterior chamber in group Ⅱ was deepened from 1.92 ± 0.52mm preoperatively to 3.18 ± 0.39mm postoperatively at 3 months. Postoperative central anterior chamber depth were significantly deeper than before surgery, there was a significant difference (P <0.05), anterior chamber angle widened significantly. Conclusion: Phacoemulsification and intraocular lens (IOL) implantation can not only improve glaucoma visual acuity after laser iridectomy, but also completely relieve pupillary block of angle-closure glaucoma.