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目的 :评价超声乳化吸除术联合虹膜周边切除术和联合小梁切除术对白内障合并闭角型青光眼的手术效果。方法 :回顾性分析 2 0 0 1年 4月至 12月白内障合并原发性闭角型青光眼患者行青光眼白内障联合手术 34例 4 0只眼。其中 15例 17只眼行超声乳化吸除术联合虹膜周边切除术 ,19例 2 3只眼行超声乳化吸除术联合小梁切除术。术后随访 3个月。结果 :虹膜周边切除术组术后眼压 (15 78± 4 5 2 )mmHg ,小梁切除术组术后眼压 (17 71± 3 1)mmHg ,均较术前有显著性差异(P <0 0 1)。两组间术后 1周 ,1、3个月均无显著性差异 (P >0 0 5 )。虹膜周边切除术组术后视力≥ 0 5者 13只眼 (占76 4 7% ) ,小梁切除术组 14只眼 (占 6 0 87% )。术后各种并发症、虹膜周边切除术组为 4只眼 (2 3 5 % ) ,小梁切除术组 15只眼 (6 5 2 2 % )。结论 :超声乳化联合虹膜周边切除术或小梁切除术均可以明显降低闭角型青光眼的眼压 ,提高视力。但虹膜周边切除术手术操作简单 ,术后并发症少 ,恢复快
Objective: To evaluate the effect of phacoemulsification combined with peri-iridectomy and trabeculectomy on cataract combined with angle-closure glaucoma. Methods: A retrospective analysis of 40 patients with cataract combined with primary glaucoma and cataract surgery in 40 patients with primary angle closure glaucoma from April to December 2001 was performed. Fifteen of 17 eyes underwent phacoemulsification combined with peri-iridectomy and 19 cases of 23 underwent phacoemulsification combined with trabeculectomy. Follow-up 3 months after operation. Results: The intraocular pressure (15 78 ± 45 2) mmHg after operation in iris group and the intraocular pressure (17 71 ± 31) mmHg after trabeculectomy group were significantly different from those before operation (P < 0 0 1). There was no significant difference between the two groups in 1 week, 1, 3 months after operation (P> 0.05). There were 13 eyes (76.47%) with visual acuity ≥ 0.5 and 14 eyes (6 87%) in trabeculectomy group. In the postoperative complications, 4 eyes (23.5%) underwent iris resection and 15 eyes (652 2%) underwent trabeculectomy. Conclusion: Phacoemulsification combined with peri-iris resection or trabeculectomy can significantly reduce the intraocular pressure and improve visual acuity in angle-closure glaucoma. However, the surgical resection of iris peripheral excision is simple, less postoperative complications, faster recovery