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目的 :研究原发性闭角型青光眼合并白内障患者在白内障摘除及人工晶体植入术后房角形态的改变 ,揭示白内障手术对闭角型青光眼房角形态的影响。方法 :分别用中央前房深度仪、前房角镜、裂隙灯显微镜、Schi tz压陷式眼压计对 2 8例 ( 2 8只眼 )闭角型青光眼合并白内障连续病例手术前后的中央前房深度、房角形态、眼压进行对照观察 ,其中有 6例病人用UBM检查手术前后的房角情况。结果 :术后中央前房深度加深者 2 8例 ( 1 0 0 % ) ,眼压不同程度下降者 2 3例 ( 82 % ) ,房角增宽者 2 1例( 75% ) ,术前房角有粘连者 2 1例 ,术后粘连范围减少者 1 1例 ( 52 % )。UBM检查发现瞳孔阻滞性闭角型青光眼在白内障术后 ,中央前房加深 ,虹膜由膨隆变为平坦 ,房角入口由狭窄、关闭变为增宽、开放 ,睫状体在白内障术后发生后移 ;非瞳孔阻滞性闭角型青光眼在白内障术后 ,虹膜根部附着位置与形态及睫状体的形态与位置无明显改变 ,房角没有增宽和开放。结论 :瞳孔阻滞性闭角型青光眼合并白内障患者在白内障术后由于瞳孔阻滞解除 ,房角均可较术前不同程度增宽 ,甚至部分非牢固粘连区可再开放 ,所以 ,应先行单纯白内障摘除及人工晶体植入术 ,术后对房角和眼压再评价 ,然后针对术后房角和眼压状态作出对青光眼的处理 ;非瞳孔?
Objective: To study the changes of the angle of the angle after cataract extraction and intraocular lens implantation in patients with primary angle-closure glaucoma complicated with cataract and to reveal the effect of cataract surgery on the angle shape of angle-closure glaucoma. Methods: A total of 28 patients (28 eyes) with angle - closure glaucoma were treated with a central anterior chamber depth instrument, a gonioscopy, a slit lamp microscope and a Schizophrenia tonometer. The depth of the chamber, the morphology of the angle of the corner and the intraocular pressure were observed and controlled. Among them, 6 patients had UBM before and after the surgery. Results: Postoperative central anterior chamber deepened 28 cases (100%), decreased intraocular pressure in varying degrees, 23 cases (82%), angle widening 21 cases (75%), preoperative There were 21 cases of adhesions in the corner and 11 cases (52%) of cases with reduced adhesion. UBM examination revealed pupillary block angle-closure glaucoma after cataract surgery, the central anterior chamber deepened, the iris changes from bulging to flat, angle entrance from the narrow, open to widened, open, ciliary body occurs after cataract surgery After cataract surgery, non-pupillary block angle-closure glaucoma showed no significant changes in the location and morphology of the iris root and the morphology and location of the ciliary body. The angle was not widened and open. Conclusions: The pupillary block angle-closure glaucoma patients with cataract were relieved of pupillary block after cataract surgery. The angle of the angle can be broadened to some extent compared with that before operation, and even some of the non-firm adhesion areas can be reopened. Therefore, Cataract extraction and intraocular lens implantation, postoperative assessment of angle and intraocular pressure, and then for postoperative angle and intraocular pressure to make glaucoma treatment; non-pupil?