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[房角镜下超声乳化白内障吸除联合房角粘连分离术治疗闭角型青光眼:开放粘连性前房角的效果]

[Phacoemulsification combined with goniosynechialysis under a gonioscope in the treatment of angle-closure glaucoma: the effect of reopening the synechial anterior chamber angle].

作者信息

Tang Y H, Li Y Y, Xie Y Q, Zhang S D, Xu S X, Le R R, Chu X Z, Hu C J, Wang X J, Pan W H, Liang Y B

机构信息

The Eye Hospital, School of Ophthalmology and Optometry, Glaucoma Research Institute, Wenzhou Medical University, National Clinical Research Center for Ocular Diseases, Wenzhou 325027, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2022 Sep 11;58(9):701-705. doi: 10.3760/cma.j.cn112142-20211127-00565.

Abstract

A total of 170 consecutive patients (181 eyes) who were diagnosed with primary angle-closure glaucoma (PACG) and underwent phacoemulsification and intraocular lens implantation (PEI) combined with goniosynechialysis (GSL) with an instrument under a gonioscope in the Eye Hospital, Wenzhou Medical University from January 1, 2017 to December 31, 2019 were observed. Anterior chamber angle synechiae of 0 (0, 2) clock hour were released after PEI, while after combined goniosynechialysis, synechiae of 6 (3, 8) clock hours were further released. No matter in chronic PACG and acute PACG with cornea edema, the extent of anterior chamber angle synechiae was different before surgery and after PEI, and so was it in post-PEI and PEI-GSL prospectively (all <0.01). Phacoemulsification alone can reopen the synechial anterior chamber angle in both chronic PACG and acute PACG in part, but not sufficiently. Combined goniosynechialysis under a gonioscope with an instrument is essential and effective.

摘要

观察了2017年1月1日至2019年12月31日期间在温州医科大学眼视光医院被诊断为原发性闭角型青光眼(PACG)并接受超声乳化白内障吸除联合人工晶状体植入术(PEI)以及在房角镜下使用器械进行房角粘连分离术(GSL)的170例连续患者(181只眼)。PEI术后松解了0(0, 2)钟点位的前房角粘连,而联合房角粘连分离术后,进一步松解了6(3, 8)钟点位的粘连。无论在慢性PACG还是伴有角膜水肿的急性PACG中,术前与PEI术后前房角粘连的程度均不同,PEI术后与PEI - GSL术后相比也是如此(均<0.01)。单纯超声乳化白内障吸除术在一定程度上可部分重新开放慢性PACG和急性PACG中粘连的前房角,但并不充分。在房角镜下使用器械进行联合房角粘连分离术至关重要且有效。

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