关键词: 原发性闭角型青光眼, 白内障, 小梁消融术

Abstract:

Objective To observe the safety and efficacy of trabectome combined with phacoemulsification and goniosynechialysis for the patients with primary angle-closure glaucoma (PACG) combined with cataract. Design Retrospective case series. Participants Sixteen patients who has indication of glaucoma filtering surgery combined with phacoemulsification were included in this study. Methods Trabectome combined with phacoemulsification and goniosynechialysis were performed after eye examinations. During the operation, phacoemulsification and intraocular lens implantation combined with goniosynechialysis were performed first, and then trabectome was performed. The trabecular ablation ranged from 90 to 120 degrees on the nasal side. The follow-up was 6 months. Main Outcome Measures Intraocular pressure (IOP), the number of glaucoma medications, postoperative complications. Results All of the 16 patients, 14(87.5%) were followed up for 6 months. IOP was reduced from (33.4±12.4) mmHg to (13.3±1.8) mmHg with statistical significance (P =0.000). Meanwhile the number of glaucoma medications was reduced from (2.0±0.5) to (0.5±0.7) at six months with statistical significance (P=0.000). When trabecular meshwork was ablated during operation, there was no other serious complication occurred except for hyphema. One case had a temporary IOP elevation. One case had the anterior synechia. Conclusion Trabectome combined with phacoemulsification and goniosynechialysis can reduce IOP and the number of glaucoma medications significantly for the patients with PACG combined with cataract, who has indication of glaucoma filtering surgery combined with phacoemulsification. Long-term efficacy needs further verification. (Ophthalmol CHN, 2019, 28: 285-288)

Key words: primary angle-closure glaucoma, cataract, trabectome