Crichton A C, Kirker A W
Department of Surgery, University of Calgary, Alberta, Canada.
J Glaucoma. 2001 Feb;10(1):38-46. doi: 10.1097/00061198-200102000-00008.
To determine whether clear corneal phacoemulsification and the implantation of a copolymer acrylic (AcrySof, Alcon, Fort Worth, TX) intraocular lens will maintain the intraocular pressure (IOP) and number of medications in patients with a previous filtering bleb.
This retrospective analysis included 69 consecutive patients with previous trabeculectomy who had a copolymer acrylic intraocular lens implanted during cataract surgery between 1995 and 1999 by a single surgeon (A.C.S.C.).
Mean IOP significantly decreased from 26.03 mm Hg (range, 14.5-70 mm Hg; n = 69) before trabeculectomy to 13.58 +/- 3.98 mm Hg (range, 5-24 mm Hg; n = 69) before the cataract extraction. After cataract extraction, the mean IOP increased significantly by 1.49 mm Hg (n = 67; P = 0.0013), by 1.85 mm Hg (n = 57; P = 0.0005), and by 1.01 mm Hg (n = 67; P = 0.042) after 6 months, after 1 year, and at the patient's last appointment, respectively. When patients whose pressures were purposely increased during cataract surgery were not included (n = 5), the mean increase at the last appointment was not significantly increased (0.54 mm Hg; n = 62; P = 0.25). The average number of antiglaucoma medications decreased from 2.93 (range, 1-5; n = 69) before trabeculectomy to 0.36 (range, 0-2; n = 69) before cataract surgery. This mean decreased to 0.34 (range, 0-2; n = 67; P = 0.8366) 6 months after cataract surgery and increased to 0.49 (range, 0-3; n = 57; P = 0.1029) and 0.62 (range, 0-3; n = 67; P = 0.0006) after 1 year and at the last appointment, respectively. Of the total study population, two (2.9%) patients required additional glaucoma surgery and 14 (20.3%) patients required additional antiglaucoma medications as compared with their precataract levels.
Clear corneal phacoemulsification and the implantation of a copolymer acrylic (AcrySof, Alcon) posterior chamber intraocular lens statistically increased the number of medications and IOP of patients in our study. These increases, although statistically significant, did not cause a clinically significant deterioration in IOP control.
确定透明角膜超声乳化术联合植入丙烯酸共聚物（爱尔康公司生产的AcrySof，位于德克萨斯州沃思堡）人工晶状体是否能维持既往有滤过泡患者的眼压（IOP）及药物使用数量。
这项回顾性分析纳入了69例连续的既往接受小梁切除术的患者，这些患者于1995年至1999年间由同一位外科医生（A.C.S.C.）在白内障手术期间植入了丙烯酸共聚物人工晶状体。
小梁切除术前行小梁切除术时平均眼压从26.03毫米汞柱（范围14.5 - 70毫米汞柱；n = 69）显著降至白内障摘除术前的13.58±3.98毫米汞柱（范围5 - 24毫米汞柱；n = 69）。白内障摘除术后，平均眼压在术后6个月、1年及患者最后一次就诊时分别显著升高1.49毫米汞柱（n = 67；P = 0.0013）、1.85毫米汞柱（n = 57；P = 0.0005）和1.01毫米汞柱（n = 67；P = 0.042）。当排除白内障手术期间眼压故意升高的患者（n = 5）后，最后一次就诊时的平均升高不显著（0.54毫米汞柱；n = 62；P = 0.25）。抗青光眼药物的平均使用数量从小梁切除术前行小梁切除术时的2.93（范围1 - 5；n = 69）降至白内障手术前的0.36（范围0 - 2；n = 69）。白内障手术后6个月，这一平均值降至0.34（范围0 - 2；n = 67；P = 0.8366），术后1年及最后一次就诊时分别升至0.49（范围0 - 3；n = 57；P = 0.1029）和0.62（范围0 - 3；n = 67；P = 0.0006）。在整个研究人群中，与白内障手术前相比，有2例（2.9%）患者需要额外的青光眼手术，14例（20.3%）患者需要额外的抗青光眼药物。
在我们的研究中，透明角膜超声乳化术联合植入丙烯酸共聚物（爱尔康公司的AcrySof）后房型人工晶状体在统计学上增加了患者的药物使用数量和眼压。这些增加虽然在统计学上显著，但并未导致眼压控制出现临床上的显著恶化。
