【摘要】 [HTK〗观察白内障囊外摘除人工晶体植入联合房角分离术治疗合并有白内障的急性闭角型青光眼的疗效，以及术后房角形态的改变。方法:白内障囊外摘除联合房角分离术治疗急性闭角型青光眼34例(37眼)，对其手术前后的视力、眼压、视野、中央前房深度、房角形态进行对照观察。结果:手术180?d后随访，34例(37眼)中有28例(30眼)视力较术前显著提高。术前前房深度（1.674±0.478）ｍｍ，眼压（28.436±3.325）ｍｍＨｇ，术后30?d前房深度(3.412±0.169)ｍｍ，术后7?d眼压(13.983±5.196)ｍｍＨｇ。术后30?d房角镜检查34例(37眼)房角均开放。27例(28眼)术后6个月复查视野无缩小。结论：白内障囊外摘除联合房角分离术能使此类患者降低眼压、加深前房、开放房角和提高视力。
【关键词】 白内障囊外摘除术 房角分离术 青光眼 闭角型
AExtracapsular cataract extraction combined with
goniosynechialysis for acute angle closure glaucoma
LIU Yongmei1, TIAN Xu2， ZHANG Shuang1， ZHANG Linna1
（ Department of Ophthalmology, 1. Qilu Hospital of Shandong University, Jinan 250012, Shandong, China;
2. Shandong University Hospital, Jinan 250061, Shandong, China）
［ABSTRACT］ Objective: To investigate the clinical effect of extracapsular cataract extraction combined with goniosynechialysis in treatment of acute angle closure glaucoma with cataract. Methods: Thirtyfour patients (37 eyes) were subjected to this management. The anterior chamber depth, visual acuity, configuration of chamber anger, and intraocular pressure were determined. Results: After a mean postoperative followup of 180 days, the best corrected visual acuity was improved in 28 cases (30 eyes). The mean anterior chamber depth was 1.674±0.478 mm preoperatively and 3.412±0.169 mm at postoperative 30 days (t=6.743, P＜0.001). The intraocular pressure was decreased from a preoperative of 28.436±3.325 mmHg to a postoperative 7day of 13.983±5.196 mmHg (t=5.263, P＜0.001). Angles of the anterior chamber were opened at postoperative 30 days in all 34 patients. The visual field was not significantly changed in 15 patients at six months after operation. Conclusion: Extracapsular cataract extraction combined with lysis of the synechiae is safe and effective for acute angle closure glaucoma.
［KEY WORDS］ Extracapsular cataract extraction; Goniosynechialysis; Glaucoma; Angleclosure
青光眼是一种以病理性眼压升高和伴有视功能损害的常见致盲性眼病。闭角型青光眼具有浅前房、窄房角和眼轴短等特点，随着年龄增长而加重，其晶状体增厚造成相对瞳孔阻滞，而晶体摘除可加深前房，开放尚未粘连的房角，术后有部分患者眼压可得到控制，但房角粘连牢固的患者得不到改善，眼压仍高于正常水平。我们对急性闭角型青光眼合并白内障的患者行白内障囊外摘除并人工晶体植入联合房角分离术，将手术前后的临床各项指标进行比较，现将结果报告如下。
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