Kashintseva L T, Salenko S V
Oftalmol Zh. 1990(4):239-42.
The paper deals with the question about surgical treatment of patients with glaucoma associated with cataract. A new technique of one-stage extracapsular cataract extraction with sinusotrabeculotomy is proposed. Its main point is a change in the sequence of stages: stage I--opening of anterior lens capsule, stage II--antiglaucomatous operation, stage III--extraction of lenticular nucleus and masses through a corneal incision. The operation was made in 30 patients (31 ages). The follow-up period was 2 years. Normalization of intraocular pressure was achieved in all patients, in one eye--miotics had to be used. All patients showed a rise of visual functions: in 21 of 31 eyes vision rose to 0.3 and higher. In one patient vision fell after a year because of progression of the glaucomatous process in the presence of normal intraocular pressure. One-stage extracapsular cataract extraction with sinusotrabeculotomy can be made at any stage of glaucoma. By the authors' data, contraindications can be a rise of intraocular pressure above 40.0 mm Hg as well as the presence of a single eye and severe course of hypertonic disease.
本文探讨了青光眼合并白内障患者的手术治疗问题。提出了一种一期囊外白内障摘除联合鼻窦小梁切开术的新技术。其主要要点是手术步骤顺序的改变：第一步——打开晶状体前囊；第二步——抗青光眼手术；第三步——通过角膜切口摘除晶状体核及皮质。该手术应用于30例患者（31只眼）。随访期为2年。所有患者眼压均恢复正常，一只眼需使用缩瞳剂。所有患者视力均有提高：31只眼中21只眼视力提高到0.3及以上。1例患者在眼压正常的情况下，因青光眼病情进展，术后1年视力下降。一期囊外白内障摘除联合鼻窦小梁切开术可在青光眼的任何阶段进行。根据作者的数据，眼压高于40.0 mmHg、单眼以及严重的高眼压症病程可能是禁忌证。
