Shingleton B J, Jacobson L M, Kuperwaser M C
Center for Eye Research, Boston, MA, USA.
Ophthalmic Surg Lasers. 1995 Sep-Oct;26(5):414-9.
The surgical management of coexisting cataract and glaucoma is a common problem for the ophthalmologist.
We evaluated intraocular pressure (IOP) reduction and bleb formation in combined cataract and filtration surgery, comparing planned extracapsular cataract extraction (ECCE) and phacoemulsification approaches coupled with similar trabeculectomy techniques. Seventy-two eyes with primary open-angle or pseudoexfoliation glaucoma underwent combined cataract and filtration surgery. Thirty-five eyes underwent planned ECCE, intraocular lens (IOL) implantation, and trabeculectomy, and 37 eyes underwent phacoemulsification, IOL implantation and trabeculectomy. Minimum follow-up for both groups was 1 year with a mean of 16 months.
The mean IOP reduction for phacoemulsification/trabeculectomy eyes (5.0 +/- 4.3 mm Hg) was significantly lower than the mean IOP reduction for ECCE/trabeculectomy eyes (2.9 +/- 4.1 mm Hg; P < 0.03). There was no significant difference between the groups in terms of visual acuity improvement or glaucoma medication reduction.
Combined cataract and filtration surgery using phacoemulsification is associated with greater IOP reduction than combined surgery using ECCE.
白内障合并青光眼的手术治疗是眼科医生常遇到的问题。
我们评估了白内障联合滤过手术中眼压（IOP）的降低情况及滤过泡形成情况，比较了计划行囊外白内障摘除术（ECCE）和超声乳化术联合相似小梁切除术技术的效果。72例原发性开角型或假性剥脱性青光眼患者接受了白内障联合滤过手术。35例患者接受了计划的ECCE、人工晶状体（IOL）植入及小梁切除术，37例患者接受了超声乳化术、IOL植入及小梁切除术。两组的最短随访时间均为1年，平均随访时间为16个月。
超声乳化术/小梁切除术组患者的平均眼压降低值（5.0±4.3 mmHg）显著低于ECCE/小梁切除术组（2.9±4.1 mmHg；P<0.03）。两组在视力改善或青光眼药物减少方面无显著差异。
与使用ECCE的联合手术相比，使用超声乳化术的白内障联合滤过手术能使眼压降低得更多。
