现阶段对青光眼白内障联合手术的认识

眼科 ›› 2012, Vol. 21 ›› Issue (1): 3-6.

现阶段对青光眼白内障联合手术的认识

张秀兰

510060广州，中山大学中山眼科中心眼科学国家重点实验室（Email：xiulan_z@yahoo.com）

出版日期:2012-01-25 发布日期:2012-01-12

Comment on combined surgery on coexisting cataract and glaucoma

ZHANG Xiu-lan

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou 510060, China

Online:2012-01-25 Published:2012-01-12

摘要/Abstract

摘要： 对于合并白内障的青光眼，其现代的处理原则、适应证、手术方式、手术时机以及临床疗效等一直是讨论的热点。白内障超声乳化术的发展对青光眼治疗具有重要贡献。原发性闭角型青光眼手术策略应根据患者的具体情况制定，如前房角粘连范围、用降眼压药物数量、晶状体混浊程度以及视力情况等。规范、精细的白内障超声乳化术及青光眼手术技巧是选择青光眼白内障联合手术的前提。要尽量避免在急性闭角型青光眼急性期行联合手术。合并有白内障或有白内障手术指征的原发性开角型青光眼，选择青光眼白内障联合手术还是先青光眼后白内障手术抑或先白内障后青光眼手术仍需深入研究。对于其它类型的青光眼如恶性青光眼，急进地摘除晶状体也存在争议。（眼科，2012，21：3-6）

关键词: 青光眼/外科学, 白内障, 联合手术

Abstract: The advance of phacoemulsification has been making huge significant contribution to the management of glaucoma. However, management of glaucoma with coexisting cataract has raised many discussions in recent years including current treatment strategies, indications, surgical procedure, timing and outcomes. This short paper will discuss these issues. Surgical strategy of primary angle-closure glaucoma (PACG) should be determined with an individualized approach based on the degree of peripheral anterior synechiae, the number of glaucoma medications, the opacity of lens and visual functions. Proficient operation skills are needed for choosing combined surgery. Cataract extraction should be greatly avoided during acute attack stage of PACG. The effect of cataract extraction in primary open angel glaucoma (POAG) still needs further study to clarify. For other types of glaucoma such as malignant glaucoma, aggressive lens extraction is of controversial. (Ophthalmol CHN, 2012, 21:3-6)

Key words: glaucoma/ surgery, cataract, combined surgery

张秀兰. 现阶段对青光眼白内障联合手术的认识[J]. 眼科, 2012, 21(1): 3-6.

ZHANG Xiu-lan. Comment on combined surgery on coexisting cataract and glaucoma[J]. Ophthalmology in China, 2012, 21(1): 3-6.

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