Potop Vasile, Corbu Catalina
Clinical Ophthalmology Emergency Hospital Bucharest, Romania.
Rom J Ophthalmol. 2017 Oct-Dec;61(4):244-248.
Clear lens extraction can be considered a therapeutic option in angle closure glaucoma (ACG). Even if it does not represent the first choice of treatment, it can be taken into consideration when the topical treatment does not control the intraocular pressure (IOP) and iridotomy does not have a positive effect on the angle closure, especially in appositional angle closure when biometry or ultrabiomicroscopy (UBM) show lens involvement. In angle closure glaucoma, clear lens extraction represents an etiological treatment that takes into account the role of the lens in the pathogenesis of the disease. If we ignore it and we choose a filtrating surgery as therapeutic option we can end up with complications such as prolonged athalamia, corneal damage and lens opacification that will eventually require cataract surgery, but performed late and with higher risks. Before performing a filtrating surgery in ACG, we should take an UBM. We also need to choose the best moment to perform surgery, after topical treatment and iridotomy have been tested, but before trabecular damage appears.
透明晶状体摘除术可被视为闭角型青光眼（ACG）的一种治疗选择。即使它并非首选治疗方法，但当局部治疗无法控制眼压（IOP）且虹膜切开术对房角关闭无积极效果时，尤其是在相对性房角关闭且生物测量或超声生物显微镜检查（UBM）显示晶状体受累的情况下，仍可予以考虑。在闭角型青光眼中，透明晶状体摘除术是一种病因治疗方法，它考虑到了晶状体在疾病发病机制中的作用。如果我们忽视这一点而选择滤过性手术作为治疗选择，最终可能会出现诸如无晶状体期延长、角膜损伤和晶状体混浊等并发症，而这些最终都需要进行白内障手术，但手术时间较晚且风险更高。在对ACG进行滤过性手术之前，我们应进行UBM检查。我们还需要选择最佳手术时机，即在局部治疗和虹膜切开术经过测试之后，但在小梁损伤出现之前。
