青白联合术治疗虹膜劈裂合并白内障青光眼的临床疗效观察

Investigation of clinical effect of phaco-trabeculectomy and intraocular lens implantation for the treatment of iridoschisis

关键词:  虹膜劈裂  白内障超声乳化吸出术  小梁切除术  滤过泡

Key words:  iridoschisis  phacomulsification  trabeculectomy  filtering bleb

摘要:

［目的］观察超声乳化并人工晶状体植入及小梁切除术治疗虹膜劈裂合并青光眼白内障的治疗效果。［方法］对虹膜劈裂合并青光眼白内障的患者3眼行白内障超声乳化吸出术并人工晶体植入术及小梁切除术，术后观察视力、眼压、视野、结膜滤过泡、角膜、前房、虹膜、房角及人工晶状体的情况。［结果］随诊6~14个月，3例患者视力分别由术前0.2（矫正0.3），0.1（矫正0.3），0.12(矫正0.2)，提高至0.6（矫正0.7），0.5（矫正0.8），0.4（矫正0.8），术后术眼眼压波动于12~18 mmHg，视野缺损好转或无变化，滤过泡弥散，角膜光滑，角膜后少许色素KP，前房较术前明显加深，虹膜劈裂及纤维破裂范围扩大，虹膜脱色素加重，房角大量色素沉着，人工晶体位置正常，前表面少许色素沉着。［结论］虹膜劈裂合并青光眼白内障的患者行白内障超声乳化吸出并人工晶体植入术及小梁切除术术后近期效果明确，无明显并发症，远期效果有待进一步观察。

Abstract:

［Objective］To investigate the clinical effect of phaco-trabeculectomy and intraocular lens (IOL) implantation (Phaco+Trab+IOL) for the treatment of iridoschisis. ［Methods］Change of vision, intraocular pressure, vision field, filtering bleb, cornea, anterior chamberiris and anterior chamber angle of iridoschisis were studied in 3 eyes that received the treatment of Phaco+Tab+IOL. ［Results］All patients were followed up for 6-14 months after the surgery. Their visions were improved from pre-operation 0.2(correct 0.3), 0.1(correct 0.3), 0.12 (correct 0.2) to post-operation 0.6(correct 0.7), 0.5(correct 0.8), 0.4(correct 0.8) respectively. Post-operation intraocular pressures were 12-18 mmHg. The functional filtering bleb formation and vision field were getting better or same as before. Anterior chamber was deeper than before. Anterior chamber angle and surface of IOL had pigment. The range of iridoschisis became larger. ［Conclusion］Phaco+Trab+IOL for treating iridoschisis is effective and safety without serious complications in short term and needs further observation for long term.