关键词: 急性闭角型青光眼/外科学, 小梁切除术, 超声乳化白内障吸除术

Abstract: 【Abstract】 Objective To study the effect of the application of minimally invasive phacotrabeculectomy in patients with unresponsive acute angle-closure glaucoma. Design Retrospective case series. Participants 15 cases（15 eyes）with acute angle-closure glaucoma and coexisting cataract in Xijing Hospital between March 2011 to March 2013. Methods Preoperative topical corticosteroids, mannitol, methazolamide and paracentesis were applied to reduce intraocular pressure (IOP). A standard phacoemulsification was performed, followed by minimally invasive trabeculectomy with a fornix-based conjunctival flap (5 mm) and small sclera flap (3 mm). Main Outcome Measures Visual acuity, IOP, anterior chamber depth, inflammatory reaction, and bleb-related complications. Results Pre-operative average IOP was (53.13±8.82) mmHg. One week after surgery the visual acuity of all patients was improved significantly, and the IOP was (13.41 ± 3.42) mmHg. 3 and 6 months after surgery IOP was (14.65±4.21) and (15.35±5.48) mmHg, respectively. Inflammation in the anterior chamber subsided postoperatively at one week, inflammatory exudate was almost absorbed, and anterior chamber depth was significantly deeper at two weeks, with an average of (2.72 ± 0.38) mm. All 15 eyes had diffuse blebs or elevated blebs with microcystic changes in the conjunctiva between 3 months to 6 months postoperatively. Postoperative vision acuity was (0.92±0.48) at 6 months. No serious adverse complications were encountered during follow-up. Conclusion Minimally invasive trabeculectomy could reduce tissue injury and improve the safety of surgery, which is an effective method when combined with phacoemulsification in the treatment of patients with unresponsive acute angle-closure glaucoma and coexisting cataract. (Ophthalmol CHN, 2015, 24: 31-34)

Key words: acute angle-closure glaucoma/surgery, trabeculectomy, phacoemulsification