目的评价白内障超声乳化联合人工晶状体植入术治疗合并白内障的原发性闭角型青光眼的安全性和临床疗效。方法收集合并白内障的原发性闭角型青光眼患者41例（52眼）,其中21例（28眼）行白内障超声乳化联合人工晶状体植入术（治疗组）,20...目的评价白内障超声乳化联合人工晶状体植入术治疗合并白内障的原发性闭角型青光眼的安全性和临床疗效。方法收集合并白内障的原发性闭角型青光眼患者41例（52眼）,其中21例（28眼）行白内障超声乳化联合人工晶状体植入术（治疗组）,20例（24眼）行周边虹膜切除术（常规组）。对2组患者术后随访6个月,观察手术前后患者视力、眼压及抗青光眼药物使用量情况。结果 2组患者术后视力比较差异无统计学意义（P〉0.05）。术后随访6个月,治疗组患者均眼压≤21 mm Hg（1 mm Hg=0.133 k Pa）,平均眼压较术前降低（13.6±1.3）mm Hg,降压幅度达55.4%;常规组患者眼压≤21 mm Hg者18眼,21~30 mm Hg者6眼,平均眼压较术前降低（10.5±1.5）mm Hg,降压幅度达38.7%,2组比较差异有统计学意义（P〈0.05）。治疗组患眼术后无需应用抗青光眼药物,常规组患眼平均应用抗青光眼药物为（5.0±0.3）m L。结论白内障超声乳化联合人工晶状体植入术较常规抗青光眼手术更能有效降低眼压,减少术后抗青光眼药物使用量,是原发性闭角型青光眼合并白内障患者安全有效的治疗途径。展开更多
OBJECTIVE: To review the major progress in primary angle closure glaucoma (PACG). METHODS: Contents of this article were selected from the original papers or reviews related to primary angle closure glaucoma published...OBJECTIVE: To review the major progress in primary angle closure glaucoma (PACG). METHODS: Contents of this article were selected from the original papers or reviews related to primary angle closure glaucoma published in Chinese and foreign journals. A total of 76 articles were selected from several hundred original articles or reviews. The content of selected articles is in accordance with our purpose and the authors are authorized scientists in the study of glaucoma. RESULTS: Primary angle closure glaucoma is the most common type of glaucoma in the Sino-Mongoloid population. PACG in Chinese can be classified into three types depending on the mechanism of angle closure: 1. Multimechanism: 54.8% of Chinese PACG is caused by co-existing factors. The pattern of angle closure appears to mainly be creeping closure. After iridectomy, almost 40% of the cases still manifest a positive response to the darkroom provocative test and progressive synechial closure or recurrent angle closure may occur. Several mechanisms are involved in this form of PACG such as pupillary blocking component, iris crowding component and anterior positioned ciliary body. These factors can coexist in the follow patterns: pupillary blocking and iris crowding coexist; pupillary blocking and anterior positioned ciliary body coexist or three of them co-exist. 2. Pupillary block: (38.1% of Chinese PACG) is caused by iris bombe due to pupillary block with acute or subacute attack. It responds well to iridectomy or laser iridotomy. 3. Non-pupillary blocking: (7.8% of Chinese PACG). They usually have a deeper anterior chamber, and tend to be younger (below 40 years of age). Angle closure in this form of PACG is caused by: iris crowding mechanism or/and anteriorly positioned ciliary body against iris root to angle. It is critical to distinguish multi-mechanism PACG from other types. The initial treatment for this type of PACG is also iridectomy, but after the pupillary block component is eliminated by iridectomy, the residual non-pupillary blocking compo展开更多
目的比较不同手术方式治疗原发性闭角型青光眼合并白内障的疗效。方法选取2013年2月至2014年2月南通市通州区第八人民医院收治的原发性闭角型青光眼合并白内障患者92例为研究对象,共98眼,依据随机数字表法分为对照组和观察组,各46例(49...目的比较不同手术方式治疗原发性闭角型青光眼合并白内障的疗效。方法选取2013年2月至2014年2月南通市通州区第八人民医院收治的原发性闭角型青光眼合并白内障患者92例为研究对象,共98眼,依据随机数字表法分为对照组和观察组,各46例(49眼)。对照组采取单纯小梁切除术,观察组采取小梁切除术联合超声乳化白内障吸除术+人工晶状体植入术。观察对比两组患者的视力、眼压及术后并发症发生情况。结果观察组术后视力、眼压分别为(0.75±0.25)、(10.6±2.1)mm Hg(1 mm Hg=0.133 k Pa),优于对照组的(0.38±0.06)、(15.7±4.2)mm Hg,差异均有统计学意义(P<0.01);观察组总并发症发生率为8.2%(4/49),显著低于对照组的36.7%(18/49),差异有统计学意义(P<0.05)。结论小梁切除术联合超声乳化白内障吸除术+人工晶状体植入术治疗原发性闭角型青光眼合并白内障的临床效果优于单纯小梁切除术,促进患者视力恢复,有效控制眼压,且不良反应少,值得临床推广应用。展开更多
文摘目的评价白内障超声乳化联合人工晶状体植入术治疗合并白内障的原发性闭角型青光眼的安全性和临床疗效。方法收集合并白内障的原发性闭角型青光眼患者41例（52眼）,其中21例（28眼）行白内障超声乳化联合人工晶状体植入术（治疗组）,20例（24眼）行周边虹膜切除术（常规组）。对2组患者术后随访6个月,观察手术前后患者视力、眼压及抗青光眼药物使用量情况。结果 2组患者术后视力比较差异无统计学意义（P〉0.05）。术后随访6个月,治疗组患者均眼压≤21 mm Hg（1 mm Hg=0.133 k Pa）,平均眼压较术前降低（13.6±1.3）mm Hg,降压幅度达55.4%;常规组患者眼压≤21 mm Hg者18眼,21~30 mm Hg者6眼,平均眼压较术前降低（10.5±1.5）mm Hg,降压幅度达38.7%,2组比较差异有统计学意义（P〈0.05）。治疗组患眼术后无需应用抗青光眼药物,常规组患眼平均应用抗青光眼药物为（5.0±0.3）m L。结论白内障超声乳化联合人工晶状体植入术较常规抗青光眼手术更能有效降低眼压,减少术后抗青光眼药物使用量,是原发性闭角型青光眼合并白内障患者安全有效的治疗途径。
文摘OBJECTIVE: To review the major progress in primary angle closure glaucoma (PACG). METHODS: Contents of this article were selected from the original papers or reviews related to primary angle closure glaucoma published in Chinese and foreign journals. A total of 76 articles were selected from several hundred original articles or reviews. The content of selected articles is in accordance with our purpose and the authors are authorized scientists in the study of glaucoma. RESULTS: Primary angle closure glaucoma is the most common type of glaucoma in the Sino-Mongoloid population. PACG in Chinese can be classified into three types depending on the mechanism of angle closure: 1. Multimechanism: 54.8% of Chinese PACG is caused by co-existing factors. The pattern of angle closure appears to mainly be creeping closure. After iridectomy, almost 40% of the cases still manifest a positive response to the darkroom provocative test and progressive synechial closure or recurrent angle closure may occur. Several mechanisms are involved in this form of PACG such as pupillary blocking component, iris crowding component and anterior positioned ciliary body. These factors can coexist in the follow patterns: pupillary blocking and iris crowding coexist; pupillary blocking and anterior positioned ciliary body coexist or three of them co-exist. 2. Pupillary block: (38.1% of Chinese PACG) is caused by iris bombe due to pupillary block with acute or subacute attack. It responds well to iridectomy or laser iridotomy. 3. Non-pupillary blocking: (7.8% of Chinese PACG). They usually have a deeper anterior chamber, and tend to be younger (below 40 years of age). Angle closure in this form of PACG is caused by: iris crowding mechanism or/and anteriorly positioned ciliary body against iris root to angle. It is critical to distinguish multi-mechanism PACG from other types. The initial treatment for this type of PACG is also iridectomy, but after the pupillary block component is eliminated by iridectomy, the residual non-pupillary blocking compo
文摘目的比较不同手术方式治疗原发性闭角型青光眼合并白内障的疗效。方法选取2013年2月至2014年2月南通市通州区第八人民医院收治的原发性闭角型青光眼合并白内障患者92例为研究对象,共98眼,依据随机数字表法分为对照组和观察组,各46例(49眼)。对照组采取单纯小梁切除术,观察组采取小梁切除术联合超声乳化白内障吸除术+人工晶状体植入术。观察对比两组患者的视力、眼压及术后并发症发生情况。结果观察组术后视力、眼压分别为(0.75±0.25)、(10.6±2.1)mm Hg(1 mm Hg=0.133 k Pa),优于对照组的(0.38±0.06)、(15.7±4.2)mm Hg,差异均有统计学意义(P<0.01);观察组总并发症发生率为8.2%(4/49),显著低于对照组的36.7%(18/49),差异有统计学意义(P<0.05)。结论小梁切除术联合超声乳化白内障吸除术+人工晶状体植入术治疗原发性闭角型青光眼合并白内障的临床效果优于单纯小梁切除术,促进患者视力恢复,有效控制眼压,且不良反应少,值得临床推广应用。
