[1]刘平,苏胜.闭角型青光眼合并白内障手术方案的选择[J].眼科新进展,2021,41(2):101-104.[doi:10.13389/j.cnki.rao.2021.0021]
　LIU Ping,SU Sheng.Selection of surgical procedures for angle closure glaucoma complicated with cataract[J].Recent Advances in Ophthalmology,2021,41(2):101-104.[doi:10.13389/j.cnki.rao.2021.0021]
点击复制

闭角型青光眼合并白内障手术方案的选择/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
41卷
期数:
2021年2期
页码:
101-104
栏目:
述评
出版日期:
2021-02-05

文章信息/Info

Title:
Selection of surgical procedures for angle closure glaucoma complicated with cataract
作者:
刘平; 苏胜
150001　黑龙江省哈尔滨市，哈尔滨医科大学附属第一医院眼科医院
Author(s):
LIU Ping; SU Sheng
Eye Hospital,the First Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang Province,China
关键词:
闭角型青光眼; 白内障; 房角分离; 小梁切除术; 超声乳化
Keywords:
angle closure glaucoma;  cataract;  goniodialysis;  trabeculectomy;  ultrasonic phacoemulsification
分类号:
R775.9
DOI:
10.13389/j.cnki.rao.2021.0021
文献标志码:
A
摘要:
青光眼是全球仅次于白内障的致盲性眼病，严重损害人们的视力。青光眼合并白内障的诊疗一直是眼科临床研究的热点。随着眼科医师的临床实践，青光眼，尤其是闭角型青光眼合并白内障的手术方案经历了较大的变革。经典的小梁切除术、传统的三联手术（超声乳化白内障吸除+人工晶状体植入+小梁切除术），以及近年不断拓宽适应证的白内障联合房角分离术，这些术式如何选择是白内障及青光眼诊疗医师要面对的重要问题。尽管青光眼合并白内障的患者通常具有共同的特性，但是个体差异性同样突出，如发病后就诊时机、眼部解剖结构、就诊医疗机构的条件、主治医师技术特点的差异等均会对术式的选择有重要影响。本文结合临床研究报道以及临床实践经验，对不同手术方案进行分析，以期推动闭角型青光眼合并白内障诊疗的讨论和研究。
Abstract:
Glaucoma is a blinding eye disease which is second only to cataract in the world, which seriously damages human vision. The diagnosis and treatment of glaucoma complicated with cataract has always been a hot spot in ophthalmic clinical research. With the clinical practice of ophthalmologists, the surgical scheme of glaucoma, especially angle closure glaucoma with cataract, has undergone great changes. How to choose the classic trabeculectomy, the traditional triple surgery (ultrasonic phacoemulsification + intraocular lens implantation + trabeculectomy), and the phacoemulsification combined with goniosynechiasis, which has been expanding the indications in recent years, are the important problems that cataract and glaucoma doctors must face. Although the patients with glaucoma and cataract usually have common characteristics, the individual differences are also prominent, such as the opportunity of seeing a doctor after the onset of the disease, the anatomical structure of the eye, the conditions of the medical institutions, and the technical characteristics of the attending doctors will have an important impact on the choice of surgical methods. In this paper, combined with clinical research and our clinical practice experience, the different surgical schemes were analyzed in order to promote the treatment of angle closure glaucoma complicated with cataract.

参考文献/References:

［1］　李鹏，王莉，高丹宇． 晶体因素在原发性闭角型青光眼发病机制中的影响 ［J］.实用医学杂志，2010,26(19):3505-3507.
LI P,WANG L,GAO D Y.Effect of lens parameters on the pathogenosis of primary angle-closure glaucoma ［J］.J Pract Med,2010,26(19):3505-3507.
［2］　CHEN J,ZOU Y P.Endoscope-assisted goniosynechialysis combined with phacoemulsification and intraocular lens implantation to manage primary angle-closure glaucoma ［J］.Int J Ophthalmol,2013,6 (2):174-177.
［3］　AUNG T,TOW S L,YAP E Y,CHAN S P,SEAH S K.Trabeculectomy for acute primary angle closure ［J］.Ophthalmology,2000,107(7):1298-1302.
［4］　RODRIGUES I A,ALAGHBAND P,BELTRAN AGULLO L,GALVIS E,JONES S,HUSAIN R,et al.Aqueous outflow facility after phacoemulsification with or without goniosynechialysis in primary angle closure:a randomised controlled study ［J］.Br J Ophthalmol,2017,101(7):879-885.
［5］　ZHANG H,TANG G,LIU J.Effects of phacoemulsification combined with goniosynechialysis on primary angle-closure glaucoma ［J］.J Glaucoma,2016,25(5):499-503.
［6］　RAZEGHINEJAD M R,RAHAT F.Combined phacoemulsification and viscogoniosynechialysis in the management of patients with chronic angle closure glaucoma ［J］.Int Ophthalmol,2010(30):353-359.
［7］　VARMA D,BAYLIS O,WRIDE N,PHELAN P S,FRASER S G.Viscogonioplasty:an effective procedure for lowering intraocular pressure in primary angle closure glaucoma ［J］.Eye,2007,21:472-475.
［8］　IMAIZUMI M,TAKAKI Y,YAMASHITA H.Phacoemulsification and intraocular lens implantation for acute angle closure not treated or previously treated by laser iridotomy ［J］.J Cataract Refract Surg,2006,32(1):85-90.
［9］　HARASYMOWYCZ P J,PAPAMATHEAKIS D G,AHMED I,ASSALIAN A,LESK M,AL-ZAFIRI Y,et al.Phacoemulsification and goniosynechialysis in the management of unresponsive primary angle closure ［J］.J Glaucoma,2005,14(3):186-189.
［10］　LAI J S,THAM C C,LAM D S.The efficacy and safety of combined phacoemulsification,intraocular lens implantation,and limited goniosynechialysis,followed by diode laser peripheral iridoplasty,in the treatment of cataract and chronic angle-closure glaucoma ［J］.J Glaucoma,2001,10(4):309-315.
［11］　LAI J S,THAM C C,CHAN J C.The clinical outcomes of cataract extraction by phacoemulsification in eyes with primary angle-closure glaucoma (PACG) and co-existing cataract:a prospective case series ［J］.J Glaucoma,2006,15(1):47-52.
［12］　SPAETH G L.The clinical outcomes of cataract extraction by phacoemulsification in eyes with primary angle-closure glaucoma (PACG) and co-existing cataract:a prospective case series ［J］.J Glaucoma,2006,15(4):346.
［13］　WANG N,ZHOU W,YE T,WU Z,LIU H.Clinical studies of primary angle closure glaucoma ［J］.Chin J Ophthalmol,1995,31(2):133-134.
［14］　TRAN H,LIEBMANN J R.Iridociliary apposition in plateau iris syndrome persists after cataract extraction ［J］.Am J Ophthalmol,2003,136(2):395.
［15］　UEDA J,SAWAGUCHI S,KANAZAWA S,HARA H,FUKUCHI T,WATANABE J,et al.Plateau iris configuration as a risk factor for malignant glaucoma ［J］.Nippon Ganka Gakkai Zasshi,1997,101(9):723.
［16］　TIAN T,LI M,PAN Y,CAI Y,FANG Y.The effect of phacoemulsification plus goniosynechialysis in acute and chronic angle closure patients with extensive goniosynechiae ［J］.BMC Ophthalmol,2019,19(1):65.
［17］　KAPLOWITZ K,YUNG E,FLYNN R,TSAI J C.Current concepts in the treatment of vitreous block,also known as aqueous misdirection ［J］.Surv Ophthalmol,2015,60(3):229-241.
［18］　HOSODA Y,AKAGI T,YOSHIMURA N.Two cases of malignant glaucoma unresolved by pars plana vitrectomy ［J］.Clin Ophthalmol,2014,28 (8):677-679.
［19］　张影影，张立贵，綦跃勤． 前路前段玻璃体切除术治疗青光眼白内障联合术后的恶性青光眼 ［J］． 国际眼科杂志，2016,16(12):2317-2319.
ZHANG Y Y，ZHANG L G，QI Y Q.Treatment of malignant glaucoma after surgery glaucoma combined cataract with anterior segment vitrectomy ［J］.Int Eye Sci,2016,16(12):2317-2319.
［20］　王宇冉，孔晓路，靳中良，孙利娜，侯习武，苗青． 睫状环阻滞性青光眼的阶梯治疗临床分析［J］．眼科新进展，2014,34(11):1065-1068．
WANG Y R,KONG X L,JIN Z L,SUN L N,HOU X W,MIAO Q.Clinical analysis of ladder treatment in ciliary block glaucoma［J］.Rec Adv Ophthalmol,2014,34(11):1065-1068.
［21］　PALMER J J,CHINANAYI F,GILBERT A,PILLAY D,FOX S,JAGGERNATH J,et al.Mapping human resources for eye health in 21 countries of sub-Saharan Africa:current progress towards VISION 2020 ［J］.Hum Resour Health,2014,12:44.
［22］　CARVALHO R S,DINIZ A S,LACERDA F M,MELLO P A A.Gross Domestic Product (GDP) per capita and geographical distribution of ophthalmologists in Brazil ［J］.Arq Bras Oftalmol,2012,75(6):407-411.
［23］　刘平，邹海东，胡爱莲，何明光.白内障防盲治盲工作的关键要素 ［J］.中华眼科杂志,2017,53(11):801-804.
LIU P,ZOU H D,HU A L,HE M G.Critical elements of cataract prevention work in China ［J］.Chin J Ophthalmol，2017,53(11):801-804.
［24］　姚克.青光眼白内障联合手术需重视的若干问题 ［J］.中华眼科杂志，2013,49(5):385-388.
YAO K.Surgical options and application principles of combined cataract and glaucoma surgery ［J］.Chin J Ophthalmol，2013,49(5):385-388.

相似文献/References:

[1]乔建治 张永喜.抗青光眼术后白内障行不同切口超声乳化术的临床疗效分析[J].眼科新进展,2012,32(4):000.
[2]吴星.年龄相关性白内障患者超声乳化手术前后对比敏感度分析[J].眼科新进展,2012,32(6):000.
[3]王勇 叶应嘉 鲍先议 周龑丽 许荣 彭婷婷 曾志富.同轴微小切口超声乳化吸出术在青光眼滤过术后白内障摘出术中的应用[J].眼科新进展,2012,32(7):000.
[4]徐威.注射器针头囊袋内吸附劈核法在白内障手术中的应用[J].眼科新进展,2012,32(7):000.
[5]冉文瑛 陈静 张树利.抗青光眼术后不同角膜切口白内障超声乳化术对角膜屈光状态的影响[J].眼科新进展,2012,32(7):000.
[6]王运.常规连续模式超声乳化术与爆破模式冷超声乳化术治疗白内障的临床疗效比较[J].眼科新进展,2012,32(11):000.
[7]郭照洪 王宏 宋爱平 文译 侯祺 解柳.超声乳化白内障摘出联合人工晶状体植入治疗超高度轴性近视白内障患者的临床疗效[J].眼科新进展,2013,33(1):000.
[8]刘珣 王欣玲 柏全豪 张劲松 阎启昌.IOLMaster与四种人工晶状体屈光度计算公式的准确性研究[J].眼科新进展,2013,33(2):000.
[9]张灿伟 黄旭东 姜雅琴 高婧 孙先勇 张杰 任建涛.α晶状体蛋白抗体与超声乳化术后前房炎症反应的相关性[J].眼科新进展,2013,33(6):000.
[10]唐东永 李霞 梁皓 何剑 谭少健.应用超声生物显微镜观察Bigbag人工晶状体在高度近视眼囊袋内的稳定性[J].眼科新进展,2013,33(6):000.
[11]王玲 郑振优 邢健强.白内障摘出联合人工晶状体植入术治疗闭角型青光眼合并白内障临床疗效分析[J].眼科新进展,2012,32(9):000.
[12]李成钢 陈年均.超声乳化联合房角分离术治疗闭角型青光眼合并白内障的临床疗效[J].眼科新进展,2013,33(2):000.
[13]庄靖玲.白内障超声乳化联合人工晶状体植入术在治疗闭角型青光眼合并白内障患者中的应用[J].眼科新进展,2013,33(12):000.
[14]毕宇,葛红岩,刘平. 不同手术方式对原发性闭角型青光眼合并白内障的疗效分析[J].眼科新进展,2015,35(5):442.[doi:10.13389/j.cnki.rao.2015.0120]
　BI Yu,GE Hong-Yan,LIU Ping. Different surgical types for primary angle-closure glaucoma and cataract[J].Recent Advances in Ophthalmology,2015,35(2):442.[doi:10.13389/j.cnki.rao.2015.0120]
[15]冯希敏,祁颖,张凤妍,等.超声乳化人工晶状体植入联合房角分离术治疗急性原发性闭角型青光眼合并年龄相关性白内障患者的疗效分析[J].眼科新进展,2016,36(8):767.[doi:10.13389/j.cnki.rao.2016.0205]
　FENG Xi-Min,QI Ying,ZHANG Feng-Yan,et al.Phacoemulsification with goniosynechialysis for acute primary angle-closure glaucoma with age-related cataract[J].Recent Advances in Ophthalmology,2016,36(2):767.[doi:10.13389/j.cnki.rao.2016.0205]

备注/Memo

备注/Memo:
国家自然科学基金资助（编号：81800811）
更新日期/Last Update: 2021-02-05