Gunning F P, Greve E L
Glaucoma Center, Academic Medical Center, University of Amsterdam, The Netherlands.
Int Ophthalmol. 1991 Jul;15(4):237-47. doi: 10.1007/BF00171026.
In this study we retrospectively evaluated the effect of intercapsular or extracapsular cataract extraction and posterior chamber lens implantation in 67 eyes of 57 patients with different types of primary angle closure glaucoma (PACG) in combination with cataract. We subdivided this patient population into three groups, based on the preoperative methods of intraocular pressure (IOP) control. The best results were obtained in patients with acute PACG (55% IOP reduction) and in patients with uncontrolled PACG (44% IOP reduction). In the other PACG groups an IOP reduction of between 20 and 33% was achieved. A long-term postoperative IOP of less than 21 mmHg was established in 63 eyes or 94%. In 91% the glaucoma medication was reduced, 65% of all eyes needed no glaucoma medication postoperatively. We conclude that an intercapsular cataract extraction with PC-IOL implantation should be considered in both controlled and uncontrolled PACG in patients with cataract, instead of filtering surgery or combined procedures. Even in eyes with relatively good visual acuity, cataract extraction might be considered as a means of achieving glaucoma control.
在本研究中，我们回顾性评估了57例不同类型原发性闭角型青光眼（PACG）合并白内障患者的67只眼中囊内或囊外白内障摘除及后房型人工晶状体植入的效果。我们根据术前眼压（IOP）控制方法将该患者群体分为三组。急性PACG患者（眼压降低55%）和眼压未控制的PACG患者（眼压降低44%）取得了最佳效果。在其他PACG组中，眼压降低了20%至33%。63只眼（94%）术后长期眼压低于21 mmHg。91%的患者青光眼药物用量减少，所有眼中65%术后无需使用青光眼药物。我们得出结论，对于白内障合并PACG且眼压控制或未控制的患者，应考虑行囊内白内障摘除联合后房型人工晶状体植入，而非滤过手术或联合手术。即使在视力相对较好的眼中，白内障摘除也可被视为控制青光眼的一种手段。
