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目的初步观察颞侧小切口白内障摘除联合人工晶体植入术治疗合并有白内障的原发性闭角型青光眼的疗效。方法合并有不同程度白内障的原发性闭角型青光眼患者48例(52只眼),入院用药物控制眼压正常或接近正常后,均行颞侧小切口白内障摘除合并人工晶体植入术,术前及术后3个月～1年检查视力、眼压、前房深度和房角。结果术后46只眼(88.5%)裸眼视力均有不同程度的提高。术后38只眼(73.1%)眼压低于21mmHg(1mmHg=0.133kPa),术前、术后眼压比较差异有统计学意义(P<0.01)。术前、术后前房深度分别为(1.95±0.41)mm、(3.54±0.50)mm,相比较差异有统计学意义(P<0.01)。术后所有房角均较术前有不同程度的增宽和开放,粘连范围缩小或消失,无1例浅前房、低眼压和恶性青光眼并发症发生。结论颞侧小切口非超乳白内障囊外摘除合并人工晶体植入术治疗合并白内障的闭角型青光眼,具有经济、安全、有效、易于推广的优点,可达到降低眼压、提高视力和保留角膜上方青光眼手术位置的目的 。
Objective To observe the curative effect of temporal small incision cataract extraction combined with intraocular lens implantation in the treatment of primary angle-closure glaucoma with cataract. Methods Forty-eight patients (52 eyes) with primary angle-closure glaucoma with varying degrees of cataract were treated with small incision cataract extraction combined with intraocular lens implantation (IOP) after admission with controlled or normal intraocular pressure (IOP) Visual acuity, intraocular pressure, anterior chamber depth and angle were examined preoperatively and 3 months to 1 year after surgery. Results 46 eyes (88.5%) had uncorrected visual acuity improved to some extent. The postoperative IOP of 38 eyes (73.1%) was lower than 21mmHg (1mmHg = 0.133kPa). There were significant differences in IOP before and after operation (P <0.01). The preoperative and postoperative anterior chamber depth were (1.95 ± 0.41) mm and (3.54 ± 0.50) mm, respectively, with statistical significance (P <0.01). Postoperatively, all the anterior chamber angles were widened and opened to varying degrees compared with that before operation, and the adhesion area reduced or disappeared. No one case of shallow anterior chamber hypoplasia and malignant glaucoma occurred. Conclusions Temporal small incision extracapsular cataract extracapsular cataract extraction combined with intraocular lens implantation for the treatment of angle-closure glaucoma with cataract is economical, safe, effective and easy to popularize, which can reduce intraocular pressure, improve vision and preserve the cornea Glaucoma surgery purposes above the location.