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目的探讨超声乳化晶状体摘除联合前部玻璃体切除治疗睫状环阻滞性青光眼手术要点及临床疗效。方法自2002年1月至2008年6月对8例11眼中、晚期睫状环阻滞性青光眼、持续无前房、大晶状体以及采用抽水囊联合前房成形术无效者,采用超声乳化晶状体摘除(视囊袋完整情况Ⅰ期囊袋内植入人工晶状体)联合前部玻璃体切除治疗。结果6例8眼I期囊袋内植入人工晶状体;1例2眼因撕囊失败未植入人工晶状体,术后配戴眼镜;1例1眼本次术前已行人工晶状体植入。本组病例经6个月～2年随访,1例1眼前房反复变浅,眼压失控,余前房均重建成功,深浅正常,眼压下降至正常范围;2例2眼视力无光感(1例1眼术前即无光感),余均不同程度提高。结论①超声乳化晶状体摘除联合前部玻璃体切除是治疗中、晚期睫状环阻滞青光眼、持续无前房、大晶状体以及采用玻璃体积液抽出联合前房成形术无效者的有效术式;②准确的囊袋内人工晶状体植入是术后视力重建的保障,否则术后应配戴眼镜矫正,以免睫状沟植入其襻刺激葡萄膜组织,导致睫状环阻滞性青光眼复发或产生其他病变。
Objective To investigate the surgical treatment of ciliary loop-induced glaucoma by phacoemulsification with anterior vitrectomy and its clinical effect. Methods From January 2002 to June 2008, 8 patients (11 eyes) with advanced or advanced ciliary loop-induced glaucoma, anterior continuous anterior chamber, large lens, and anterior chamber atypical pterygium were treated with phacoemulsification (Depending on the complete condition of the pouch, intraocular lens implantation in stage I capsulotomy) combined with anterior vitrectomy. Results IOLs were implanted in 6 cases of 8 cases with stage I capsulorhexis. I cases were not implanted intraocular lens in 1 case due to failure of capsulorhexis and were wearing glasses after operation. One case had intraocular lens implantation in one case. This group of patients after 6 months to 2 years follow-up, 1 case of anterior chamber repeated shallow light, intraocular pressure loss of control, the remaining room were reconstructed successfully, the normal depth, intraocular pressure decreased to the normal range; 2 cases of 2 eyes no light perception (1 patient had no light feeling before surgery), all of which improved to varying degrees. Conclusion ① phacoemulsification combined with anterior vitrectomy is the treatment of advanced ciliary loop glaucoma, persistent anterior chamber, large lens and the use of vitreous humor extract combined with anterior chamber hypoplasia effective procedures; ② accurate Capsular intraocular lens implantation is the protection of visual acuity after surgery, or glasses should be worn after surgery to avoid the ciliary sulcus implants to stimulate their umbilical tissue, leading to recurrence of ciliary loop-induced glaucoma or other Lesions.