Klink T H, Müller M, Zierhut M, Geerling G
Universitätsklinikum, Julius-Maximilians-Universität Würzburg, Josef-Schneider-Strasse 11, 97080, Würzburg, Deutschland.
Ophthalmologe. 2010 May;107(5):403-8. doi: 10.1007/s00347-009-2062-6.
The coincidence of cataract and glaucoma is increasing due to population development. Trabeculectomy is still the most commonly used procedure in combined glaucoma-cataract surgery. However, a two-step approach, starting with cataract surgery should be preferred to minimize the risk of secondary filtering bleb scarring. Postoperative fibrin exudation and the complication rate are more pronounced after combined trabeculectomy compared to combined trabeculotomy and non-penetrating glaucoma surgery. Canaloplasty is a new innovative non-penetrating glaucoma procedure. The results after canaloplasty show an even lower intraocular pressure (IOP) after combined procedures compared to canaloplasty alone. Long-term results have to confirm a sustained decrease of IOP. Surgery of the chamber angle combined with cataract surgery has hardly any complications and preserves the conjunctiva. It also allows medication to be saved and more invasive surgery to be postponed.
随着人口发展,白内障与青光眼的并发情况日益增多。小梁切除术仍是青光眼合并白内障手术中最常用的术式。然而,为将继发性滤过泡瘢痕形成的风险降至最低,应首选先进行白内障手术的两步法。与小梁切开术和非穿透性青光眼手术联合相比,小梁切除术联合术后纤维蛋白渗出和并发症发生率更为明显。睫状体光凝术是一种新型的非穿透性青光眼手术。与单独进行睫状体光凝术相比,联合手术(睫状体光凝术联合其他手术)后睫状体光凝术显示眼内压(IOP)更低。长期结果必须证实眼内压能持续降低。房角手术联合白内障手术几乎没有任何并发症,且能保留结膜。它还可以节省药物,并推迟更具侵入性的手术。