超声乳化人工晶体置入联合房角分离术治疗慢性闭角型青光眼

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Abstract Objective To study the clinical efficacy and effective factors for chronic angle-closure glaucoma after phacoemul sification and intraocular lens implantation combined with goniosynechialysis.Methods Eighty patients (92 eyes) with chronic angle-closure glaucoma undergoing phacoemulsification and intraocular lens implantation combined with goniosynechialysis from September 2008 to December 2013 were retrospectively analyzed.Ninety-two eyes were divided into four groups based on IOP control and the range of the anterior angle closure and peripheral anterior synechiae(PAS) before operation. Group 1(G1) 42 eyes (IOP≤25 mmHg and the range of angle closure and PAS≤270 degree). Group 2(G2) 12 eyes (IOP ≤25 mmHg and the range of angle closure and PAS＞270 degree). Group 3(G3) 10 eyes (IOP>25 mmHg and the range ≤270 degree). Group 4(G4) 28 eyes (IOP>25 mmHg and the range＞270 degree). Follow-up lasted 33 months (12-60m onths). Visual acuity, IOP, cental anterior chamber depth(ACD), anterior chamber volume (ACV) and anterior chamber angle(ACA) before and after operation were analyzed.Results Compared with pre-operation, the intraocular pressure(IOP) decreased and the visual acuity, ACD, ACV and ACA improved significantly post-operation (P<0.01). The improvement of visual acuity of G1 and G2 was better than G3 and G4(P<0.01) and G3 better than G4(P<0.01),though no difference was observed between G1 and G2(P>0.05) after surgery. Excepting that the IOP of G4 was higher than normal(22.98±4.54) mmHg, which of other three groups was controlled to normal and which of G1 and G2 was lower than G3(P<0.05) and G4(P<0.01),and G3 was lower than G4(P<0.05) ,while no difference was observed between G1 and G2(P<0.05). The IOP was controlled by additional medication and surgery in 20 eyes (2 of G3 and 18 of G4).Varying severity optic atrophy was observed in all eyes and correlated to the disease course. Similar to the visual acuity, ACD of G1 and G2 was deeper than that of G3 and G4 (P<0.01), and G3 deeper than G4 (P<0.05) while no difference was observed between G1 and G2. There were no differences among all groups of ACA and ACV except that the ACA of G1 was wider than G4 (P<0.01).Conclusions Phacoemulsification and intraocular lens implantation combined with goniosynechialysis for chronic angle-closure glaucoma is a safe and effective measure, which is beneficiat to visual acuity improvement and IOP long-term controll. But the clinical effects are closely related to the controlled condition of IOP, the range of anterior chamber closure and PAS before operation and disease course.

Key words： primary angle-closure glaucoma/chronic phacoemulsification intraocular lens goniosynechialysis

Received: 17 November 2015

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	Articles by authors
	DENG Deyong
	XIE Meina
	YU Dandan
	PENG Tao
	and ZHU Haiping

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DENG Deyong,XIE Meina,YU Dandan等. Clinical efficacy of phacoemulsification and intraocular lens implantation combined with goniosynechialysis for chronic angle-closure glaucoma[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2016, 27(7): 719-723.

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http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2016/V27/I7/719

[1]	Foster P J,Johnson G J.Glaucoma in China:how big is the problem？[J].Br J Ophthalmol,2001,85(11):1277-1282.
[2]	王宁利,赖铭莹.中国人闭角型青光眼房角关闭机制的研究[J].中华眼科杂志,2000,36(1): 46-51.
[3]	Caronia R M,Liebmann J M,Stegman Z,et al.Increase in iris-lens contact after laser iridotomy for pupillary block angle closure[J].Am J Ophthalmol,1996, 122(1):53-57.
[4]	孙兴怀.我国青光眼手术治疗中存在的问题与思考[J].中华眼科杂志,2009,45:5-7.
[5]	Nongpiur M E,He M,Amerasinghe N,et al.Lens vault,thickness and position in Chinese subjects with angle closure[J]. Ophthalmology. 2011,118(3):474-479.
[6]	李鹏,王莉,高丹宇.晶体因素在原发性慢性闭角型青光眼发病机制中的作用[J].西北国防医学杂志,2010,31(5):357-359.
[7]	姜雅琴,李寿庆,任建涛,等.前房角分离联合超声乳化治疗慢性闭角型青光眼伴发白内障[J].中华眼外伤职业眼病杂志,2014,36(8):565-568.
[8]	He M,Lu Y,Liu X,et al.Histologic changes of the iris in the development of angle closure in Chinese eyes[J].J Glaucoma,2008,7(5):386-392.
[9]	李睿,崔红平.原发性闭角型青光眼发病危险因素[J].中华眼科杂志,2012,48:89-92.
[10]	Lavanya R,Wong T Y,Friedman D S,et al.Determinants of angle closure in older Singaporeans[J].Arch Ophthalmol,2008 ,126(5):686-691.
[11]	Wang B S,Sakata L M,Friedman D S,et al.Quantitative iris parameters and association with narrow angles[J].Ophthalmology,2010,117(1):11-17.
[12]	Wang B S,Narayanaswamy A,Amerasinghe N,et al.Increased iris thickness and association with primary angle closure glaucoma[J].Br J Ophthalmol.2011,95(1):46-50.
[13]	Aptel F,Denis P.Optical coherence tomogTaphy quantitative analysis of iris volume changes after pharmacologic mydriasis[J].Ophthalmology,2010,117(1):3-10.
[14]	Quigley H A,Silver D M,Friedman D S,et al.Iris CreSS-sectional area decreases with pupil dilation and its dynamic behavior is a risk factor in angle closure[J].J Glaucoma,2009,18(3):173-179.
[15]	Quigley H A.The iris is a sponge:a cause of angle closure[J].Ophthalmology,2010,117(1):1-2.
[16]	范肃洁,郭黎霞,韩伟,等.联合激光治疗大范围前房角粘连慢性闭角型青光眼[J].中华眼外伤职业眼病杂志,2013,35(1O):750-752.
[17]	Sihota R, Goyal A, Kaur J, et al. Scanning electron microscopy of the trabecular meshwork: understanding the pathogenesis of primary angle closure glaucoma[J]. Indian J Ophthalmol,2012,60(3):183-188.