Hata Hiroko, Yamane Shinta, Hata So, Shiota Hiroshi
Department of Ophthalmology, Institute of Health Biosciences, University of Tokushima Graduate School, Tokushima, Japan.
J Med Invest. 2008 Aug;55(3-4):287-91. doi: 10.2152/jmi.55.287.
To evaluate effects and safety of primary phacoemulsification plus intraocular lens implantation for controlled chronic angle-closure glaucoma (CACG) or primary angle-closure (PAC).
Prospective, non-randomized comparative trial.
Two treatment groups were used. The IOL group included the use of phacoemulsification plus intraocular lens (IOL) implantation in 27 eyes. The LI group included treatment by laser iridotomy (LI) in 23 eyes. Intraocular pressure (IOP), numbers of anti-glaucoma medications, complications, and corneal endothelial cell counts were examined in each group.
In the IOL group, IOP was significantly reduced from a preoperative mean of 14.8 +/- 4.2 mmHg to a 6-month-postoperative mean of 10.8 +/- 1.6 mmHg (P < .05). However, in the LI group, mean preoperative IOP was 15.5 +/- 4.1 mmHg, and the 6-month-postoperative IOP was 14.7 +/- 4.7 mmHg (P = .76). In the IOL group, no patient used anti-glaucoma medications 6-month postoperatively, whereas in the LI group, mean number of anti-glaucoma medications was 0.2 +/- 0.4 (P < .05). There were no significant differences in preoperative and postoperative corneal endothelial cell counts between IOL and LI groups (P = .39).
Primary phacoemulsification plus intraocular lens implantation for controlled CACG or PAC seems to be a safe and effective method in reducing IOP. This procedure might become the first treatment of choice for controlled CACG or PAC with cataract.
评估原发性超声乳化白内障吸除联合人工晶状体植入术治疗控制性慢性闭角型青光眼（CACG）或原发性闭角型青光眼（PAC）的疗效及安全性。
前瞻性、非随机对照试验。
设立两个治疗组。人工晶状体组包括27只眼接受超声乳化白内障吸除联合人工晶状体（IOL）植入术。激光虹膜切开术（LI）组包括23只眼接受激光虹膜切开术治疗。检测每组的眼压（IOP）、抗青光眼药物使用数量、并发症及角膜内皮细胞计数。
人工晶状体组，眼压从术前平均14.8±4.2 mmHg显著降至术后6个月的平均10.8±1.6 mmHg（P < 0.05）。然而，激光虹膜切开术组，术前平均眼压为15.5±4.1 mmHg，术后6个月眼压为14.7±4.7 mmHg（P = 0.76）。人工晶状体组，术后6个月无患者使用抗青光眼药物，而激光虹膜切开术组，抗青光眼药物平均使用数量为0.2±0.4（P < 0.05）。人工晶状体组与激光虹膜切开术组术前和术后角膜内皮细胞计数无显著差异（P = 0.39）。
原发性超声乳化白内障吸除联合人工晶状体植入术治疗控制性CACG或PAC似乎是一种降低眼压的安全有效方法。该手术可能成为合并白内障的控制性CACG或PAC的首选治疗方法。
