Stangos Alexandros N, Mavropoulos Anestis, Sunaric-Megevand Gordana
Division of Ophthalmology, Department of Clinical Neurosciences, University Hospitals of Geneva, Geneva, Switzerland.
Clin Ophthalmol. 2007 Dec;1(4):497-504.
To evaluate the efficacy and safety of combined viscocanalostomy and phacoemulsification (phacoviscocanalostomy) for medically uncontrolled open-angle glaucoma (OAG) with concomitant age-related cataract.
Prospective, noncomparative, interventional case-series study.
Phacoviscocanalostomy was performed on 50 eyes of 50 consecutive patients with medically uncontrolled OAG and clinically significant age-related cataract. Surgical outcome was defined as an overall success by the following criteria: no visual field deterioration; no optic-neuropathy progression; postoperative intraocular pressure (IOP) </= 20 mmHg and IOP reduction >/= 30% compared to baseline values with or without medication. When medications were not required, success was defined as complete. The surgical outcome and the complication rates were documented and analyzed up to 36 months postoperatively.
Mean follow-up (+/-SD) was 29.02 +/- 7.09 months. Mean, baseline IOP (+/-SD) had significantly decreased from 23.51 +/- 4.48 mmHg to 14.06 +/- 1.64 mmHg at the last follow-up visit for each patient (p < 0.001). The overall success was 94% at 12 months, 92% at 24 months, and 82% at 36 months. The success was complete in 74% at 12 months, and in 67% at 24 months and at 36 months. No serious complications were documented.
Phacoviscocanalostomy can be considered an efficient and safe alternative surgical modality for medically uncontrolled OAG with concomitant age-related cataract.
评估小梁切开联合超声乳化术（小梁超声乳化术）治疗药物控制不佳的开角型青光眼（OAG）合并年龄相关性白内障的疗效和安全性。
前瞻性、非对比性、干预性病例系列研究。
对50例连续的药物控制不佳的OAG且患有具有临床意义的年龄相关性白内障患者的50只眼进行小梁超声乳化术。手术结果按以下标准定义为总体成功：无视野恶化；无视神经病变进展；术后眼压（IOP）≤20 mmHg，与基线值相比，眼压降低≥30%（无论是否使用药物）。当不需要药物时，成功定义为完全成功。记录并分析术后36个月内的手术结果和并发症发生率。
平均随访（±标准差）为29.02±7.09个月。每位患者最后一次随访时，平均基线眼压（±标准差）已从23.51±4.48 mmHg显著降至14.06±1.64 mmHg（p<0.001）。12个月时总体成功率为94%，24个月时为92%，36个月时为82%。12个月时完全成功率为74%，24个月和36个月时为67%。未记录到严重并发症。
小梁超声乳化术可被视为治疗药物控制不佳的OAG合并年龄相关性白内障的一种有效且安全的替代手术方式。
