Braganza A, Thomas R, George T, Mermoud A
Schell Eye Hospital, Vellore, India.
Indian J Ophthalmol. 1998 Sep;46(3):139-43.
We retrospectively analyzed 135 eyes with phacolytic glaucoma. A trabeculectomy was added to standard cataract surgery if symptoms endured for more than seven days, or if preoperative control of intraocular pressure (IOP) with maximal medical treatment was inadequate. In the early postoperative period, IOP was significantly lower in the combined surgery group (89 eyes) compared to the cataract surgery group (46 eyes) (p < 0.001). At 6 months there was no difference in IOP or visual acuity between the two groups. There were no serious complications related to trabeculectomy. It is reasonable to conclude that in eyes with a long duration of phacolytic glaucoma, addition of a trabeculectomy to cataract surgery is safe, prevents postoperative rise in intraocular pressure and decreases the need for systemic hypotensive medications. A randomized trial is on to further address this question.
我们回顾性分析了135例晶状体溶解性青光眼患者的135只眼。如果症状持续超过7天，或者最大药物治疗下术前眼压（IOP）控制不佳，则在标准白内障手术基础上加做小梁切除术。术后早期，联合手术组（89只眼）的眼压显著低于白内障手术组（46只眼）（p<0.001）。6个月时，两组间眼压和视力无差异。未发生与小梁切除术相关的严重并发症。可以合理地得出结论，对于晶状体溶解性青光眼病程较长的患者，白内障手术联合小梁切除术是安全的，可防止术后眼压升高，并减少全身降压药物的使用。一项随机试验正在进行，以进一步探讨这个问题。
