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手法小切口白内障手术联合丝裂霉素C强化小梁切除术后的视力康复与眼压控制

Visual rehabilitation and intraocular pressure control after combined manual small incision cataract surgery and mitomycin-C augmented trabeculectomy.

作者信息

Singh P, Kunhammad S

出版信息

Nepal Med Coll J. 2014 Dec;16(2-4):177-81.

Abstract

Both cataract and glaucoma are significant public health problems. Combined cataract operation and trabeculectomy is required for visual rehabilitation and control of intraocular pressure (IOP) thereby preventing progressive optic nerve damage, in patients with coexisting cataract and glaucoma. The aim of this study was to find out the visual rehabilitation and IOP control following combined manual small incision cataract surgery (SICS) and mitomycin-C (MMC) augmented trabeculectomy. In this study 45 consecutive eyes of 45 patients who had undergone combined procedures (manual SICS+ trabeculectomy with MMC) were reviewed between September 2011 and August 2012. Postoperative visual acuity and IOP were recorded at postoperative day 1, 2nd week and 6th week to see the short term outcome of surgery and any postoperative complications were recorded. Best corrected visual acuity (BCVA) at 6th week follow-up was noted. Out of 45 patients males were 31 (68.8%) and females were 14 (31.1%). Twenty nine (64.4%) patients were Primary open angle glaucoma (POAG), 11 (24.4%) Primary angle closure glaucoma (PACG), 5 (11.1%) Normal tension glaucoma (NTG) with visually significant cataract. The mean preoperative and postoperative IOP was 23.93 mmHg ± 0.75 mmHg and 11.2 mmHg ± 1.5 mmHg respectively. The mean reduction in IOP was 12.73 mmHg on the 6th week of follow up. There was statistically significant reduction in IOP on the 6th week follow up (p < 0.000 1). Twenty three patients (65.7%) achieved best corrected visual acuity between 6/6 to 6/18 and 6 patients (17.1%) had 6/24 to 6/60 on the 6th week follow up. Combined SICS with MMC augmented trabeculectomy is effective in terms of IOP control and visual rehabilitation in treating glaucoma patients with cataract.

摘要

白内障和青光眼都是严重的公共卫生问题。对于同时患有白内障和青光眼的患者,需要联合进行白内障手术和小梁切除术,以实现视力康复并控制眼压(IOP),从而防止视神经进行性损伤。本研究的目的是了解联合手动小切口白内障手术(SICS)和丝裂霉素C(MMC)强化小梁切除术后的视力康复和眼压控制情况。在本研究中,对2011年9月至2012年8月期间连续45例接受联合手术(手动SICS + 小梁切除术联合MMC)的患者的45只眼睛进行了回顾。记录术后第1天、第2周和第6周的术后视力和眼压,以观察手术的短期结果,并记录任何术后并发症。记录第6周随访时的最佳矫正视力(BCVA)。45例患者中男性31例(68.8%),女性14例(31.1%)。29例(64.4%)患者为原发性开角型青光眼(POAG),11例(24.4%)为原发性闭角型青光眼(PACG),5例(11.1%)为正常眼压性青光眼(NTG)合并有明显视力损害的白内障。术前和术后平均眼压分别为23.93 mmHg ± 0.75 mmHg和11.2 mmHg ± 1.5 mmHg。随访第6周时眼压平均降低12.73 mmHg。随访第6周时眼压有统计学意义的降低(p < 0.000 1)。23例患者(65.7%)在第6周随访时最佳矫正视力达到6/6至6/18,6例患者(17.1%)为6/24至6/60。联合SICS与MMC强化小梁切除术在治疗合并白内障的青光眼患者的眼压控制和视力康复方面是有效的。

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