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目的 对先天性青光眼合并晶状体异常的病例进行手术效果的评价 ,以探讨先天性白内障合并青光眼的最佳治疗方法和手术时机。方法 1 998年 4月～ 2 0 0 1年 2月对 7例 1 3眼先天性青光眼合并晶状体异常的病例进行了手术 ,其中 1 0眼行小梁切开 +小切口晶状体摘除 ;1眼行小梁切除 +小切口晶状体摘除 ;1人 2眼为白内障术后半年发现青光眼 ,行小梁切除术。结果 术前眼压 1 1眼(84 6% ) >40mmHg ,平均 46 5mmHg。术后平均随访 1 4 9月 ,有 1 0眼 (76 9% )于手术近期都有一过性眼压高 ,一般发生在术后 0 5～ 1月后 ,随访终末期有 4眼 (3 6 4% )眼压在 2 5～ 3 0mmHg ,眼压控制不好的主要为眼球扩张合并晶状体脱位病例。术后并发症中 1人 2眼有术后前房出血 ,1～ 2日吸收 ,无其他近期及远期并发症发生。结论 对先天性青光眼合并晶状体异常的儿童可以实施青光眼白内障联合手术。大部分病例一次手术可以完全控制眼压 ,小部分需加抗青光眼药物。手术并发症少。
Objective To evaluate the surgical effect of congenital glaucoma with lens abnormalities in order to explore the best treatment and timing of congenital cataract combined with glaucoma. Methods From April 1998 to February 2001, 7 patients with congenital glaucoma and 13 cases with congenital glaucoma underwent surgery. Among them, 10 cases underwent trabeculectomy and small incision phacoemulsification. Trabeculectomy + small incision lens removal; 1 patient 2 eyes were found glaucoma six months after surgery, trabeculectomy. Results Preoperative intraocular pressure 11 eyes (84 6%)> 40mmHg, an average of 46 5mmHg. Postoperative average follow-up During September to September, 10 (76.9%) patients had transient intraocular pressure (IOP) high in recent surgery, which usually occurred at 0-5 months after operation. There were 4 eyes at the end of follow-up 4%) intraocular pressure in 2 5 ~ 3 0mmHg, poor control of intraocular pressure mainly for the case of ocular dilation with lens dislocation. Postoperative complications occurred in 1 of 2 eyes with postoperative anterior chamber hemorrhage, absorbed 1 to 2 days without other immediate and long-term complications. Conclusions Children with congenital glaucoma with lens abnormalities may be treated with glaucoma and cataract surgery. In most cases an operation can completely control intraocular pressure, a small part of the need to add anti-glaucoma drugs. Surgical complications less.