论文部分内容阅读
目的比较不同类型急性闭角型青光眼行晶状体超声乳化吸出术后的眼压控制率及其与前房角改变的关系。设计回顾性病例系列。研究对象急性闭角型青光眼合并白内障以晶状体超声乳化治疗病例173例173眼。方法2005年1月～2007年6月,安溪明仁眼科医院的上述患者173例,通过超声生物显微镜(UBM)检查确定其前房角关闭类型为单纯瞳孔阻滞型(52.0%,90/173)、非瞳孔阻滞型(17.9%,31/173)、混合机制型(30.1%,5/173)。行超声乳化白内障吸除联合折叠型人工晶状体植入术,随访48W;通过UBM对比术前、术后前房深度、前房角变化以及眼压变化。主要指标眼压、前房角开放程度、并发症情况。结果手术后8W三种类型急性闭角型青光眼其眼压控制率分别为单纯瞳孔阻滞型88.9%(64/72)、非瞳孔阻滞型52.0%(13/25)、混合机制型83.4%(35/42),差异有统计学意义(χ2=7.13,P=0.022);随访48W时分别为54.2%(13/24)、33.3%(3/9)、35.8%(5/14),差异有统计学意义(χ2=12.56,P=0.003)。手术中及术后并发症发生率与同期单纯白内障超声乳化手术相当。48W时前房角开放率(UBM检查)分别为单纯瞳孔阻滞型66.7%(16/24)、非瞳孔阻滞型33.3%(3/9)、混合机制型33.3%(4/12)。结论急性闭角型青光眼患者行晶状体超声乳化吸出术其眼压控制有效率依次为单纯瞳孔阻滞型、混合机制型、非瞳孔阻滞型;眼压控制率与前房角开放程度有关。
Objective To compare the control rate of intraocular pressure (IOP) after phacoemulsification with different types of acute angle-closure glaucoma and its relationship with the change of anterior chamber angle. Design retrospective case series. A total of 173 patients (173 eyes) with acute angle-closure glaucoma and cataract treated by phacoemulsification were included in the study. Methods From January 2005 to June 2007, 173 patients with above-mentioned patients in Anxi Mingren Eye Hospital were examined by ultrasound biomicroscopy (UBM) to determine the type of anterior chamber angle closure as simple pupillary block (52.0%, 90/173) , Non-pupillary block type (17.9%, 31/173) and mixed type (30.1%, 5/173). Phacoemulsification combined with foldable intraocular lens implantation was followed up for 48W. The changes of anterior chamber depth, anterior chamber angle and intraocular pressure were compared by UBM. The main indicators of intraocular pressure, anterior chamber angle opening degree, complications. Results The postoperative 8W acute angle-closure glaucoma was controlled by 88.9% (64/72) of simple pupil block, 52.0% (13/25) of non-pupillary block, 83.4% of mixed mechanism (35/42), the difference was statistically significant (χ2 = 7.13, P = 0.022); 54.2% (13/24), 33.3% (3/9) and 35.8% (5/14) The difference was statistically significant (χ2 = 12.56, P = 0.003). The incidence of intraoperative and postoperative complications was comparable to that of simple cataract phacoemulsification. The anterior chamber angle opening rate (UBM test) at 48W was 66.7% (16/24) for simple pupil block, 33.3% (3/9) for nonpupillary block, and 33.3% (4/12) for mixed mechanism. Conclusions The effective rate of intraocular pressure control in patients with acute angle-closure glaucoma is as follows: simple pupil block type, mixed mechanism type and non-pupillary block type; the IOP control rate is related to the degree of anterior chamber angle opening.