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超声乳化晶状体摘除术对不同阶段原发性闭角型青光眼的疗效分析
祝远方,姚玉峰
作者单位
祝远方 浙江大学医学院附属邵逸夫医院眼科 
姚玉峰  
摘要:
目的 比较分析超声乳化晶状体摘除术对不同阶段的原发性闭角型青光眼的治疗效果,为临床上闭角型青光眼行 晶状体摘除术治疗的手术时机选择提供依据。方法 收集2008 年7 月至2013 年12 月行超声乳化晶状体囊外摘除术联合人工晶状体植入术的闭角型青光眼患者70 例(共113 眼),分为临床前期组(40 眼)、急性发作组(48 眼)和慢性进展组(25 眼)3 组,平均随访(19.47±10.10)个月。比较各组患者术前、术后的视力、眼压、视野、房角粘连等参数,以及术后随访过程中青光眼继续进展的情况。结果 临床前期组患者术后均无青光眼进展;急性发作组10.4%患者术后继续进展,继续进展和术前病程相关(r=0.462,P=0.003);慢性进展组40.0%患者术后继续进展,继续进展和房角粘连程度相关(r=0.698,P=0.000)。结论 原发性闭角型青光眼临床前期患者进行晶状体摘除可良好地预防青光眼进展;房角关闭急性发作时尽早行晶状体摘除;慢性进展期在早期,房角粘连未达1/2周之前行晶状体摘除均可有效控制病情发展。
关键词:  闭角型青光眼  晶状体摘除  超声乳化  眼压
DOI:
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基金项目:
Clinical effects of phacoemulsification on primary angle-closure glaucoma at different stages
ZHU Yuanfang,YAO Yufeng
Abstract:
Objective To evaluate the clinical effects of phacoemulsification on primary angle-closure glaucoma (PACG) at different stages. Methods One hundred and thirteen eyes fromseventeen PACG patients undergoing phacoemulsification in our hospital during July 2008 to December 2013 were enrolled, including angle closure suspects (40 eyes), acute primary angle closure(48 eyes) and progressing angle-closure glaucoma(25 eyes). The mean follow-up time was (19.47±10.10 )months. The visual acuity, intra-ocular pressure, visual field, and peripheral anterior synechiae were compared before and after surgery. Results All angle closure suspects were well controlled, 10.4%of acute primary angle-closure eyes and 40.0%of progressing angle-closure glaucoma eyes showed a further development of glaucoma. Conclusion Lens extraction surgery might be radical for angle closure suspects, but should be carried on as early as possible for acute primary angle closure, also for progressing angle-closure glaucoma.
Key words:  Angle-closure glaucoma  Lens extraction  Phacoemulsification  IOP