超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察ppt课件

超声乳化白内障吸除折叠式人工晶状体植入治疗闭超声乳化白内障吸除折叠式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察角型青光眼合并白内障的临床观察 Clinical study on the management of angle-closure glaucoma with cataract by phacoemulsification with foldable posterior chamber intraocular lens implantation 超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察1超声乳化白内障吸除折叠式人工晶状体植入治疗闭角型青光眼合并白一、目的（OBJECTIVE）初步观察颞侧角巩膜缘隧道切口超声乳化白内障吸除联合后房型折叠式人工晶状体植入术治疗合并白内障的急性或慢性闭角型青光眼的疗效。To investigate the clinical results of phacoemulsification with foldable posterior chamber intraocular lens(PC-IOL)implantation in the management of acute or chronic angle-closure glaucoma with cataract.超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察2一、目的（OBJECTIVE）初步观察颞侧角巩膜二、病例资料（PATIENTS DATA）2001年9月2003年4月收住本院的33例(52只眼)原发性 闭角型青光眼合并白内障患者男18例，女15例年龄4279岁，平均年龄57.328.64岁From September of 2001 to April of 2003 33 cases(52 eyes)with primary angle-closure glaucoma and cataract were prospectivly studied.18 men，15 womenAges were from 42 to 79，average age was 57.328.64超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察3二、病例资料（PATIENTS DATA）2001年9月1、原发性急性闭角型青光眼组（24眼）术前眼压1754mmHg，平均眼压27.6910.42mmHg 周围前房深度0.280.04 CK 平均远视力0.2 0.1 平均用降眼压药1.7种1、Primary acute angle-closure glaucoma（24 eyes）Preoperative IOP was 1754mmHg，mean IOP was 27.6910.42mmHgMean limbic anterior chamber depth was 0.280.04 CKMean visual acuity was 0.2 0.1Mean drugs was 1.7 types超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察41、原发性急性闭角型青光眼组（24眼）1、Primary a2、原发性慢性闭角型青光眼组（28眼）术前眼压1120mmHg，平均眼压16.392.50mmHg 周围前房深度0.450.08 CK 平均远视力0.3 0.2 平均用降眼压药0.8种2、Primary chronic angle-closure glaucoma（28 eyes）Preoperative IOP was 1120mmHg，mean IOP was 16.392.50mmHgMean limbic anterior chamber depth was 0.450.08 CKMean visual acuity was 0.3 0.2Mean drugs to control IOP was 0.8 types超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察52、原发性慢性闭角型青光眼组（28眼）2、Primary 三、方法（METHODS）患者入院后均行角巩膜缘隧道切口超声乳化白内障吸除联合后房型折叠式人工晶状体植入术。All the patients were undergone the Phacoemulsification with PC-IOL implantation through temporal corneal limbus tunnels.超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察6三、方法（METHODS）患者入院后均行角巩四、结果（RESULTS）原发性急性闭角型青光眼组 术后平均眼压13.132.33 mmHg 周围前房深度0.660.13 CK Primary acute angle-closure glaucoma patientsPostoperative mean IOP was 13.132.33 mmHgMean limbic anterior chamber depth was 0.660.13 CK超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察7四、结果（RESULTS）原发性急性闭角型青光眼组 术后半年平均远视力为0.50.24眼术后用一种药物控制眼压可达21mmHg以下，其余不需用药物控制眼压即正常,平均用降眼压药0.17种 Mean visual acuity was 0.50.2 half a year after operation Only 4 eyes needs one drug each to control IOP below 21mmHg and the others were normal without any drug,mean drugs used to control IOP was 0.17 types超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察8 超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型原发性急性闭角型青光眼组术前术后眼压与周围前房深度比较mmHgCK超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察9原发性急性闭角型青光眼组术前术后眼压与周围前房深度比较mm原发性急性闭角型青光眼组术前术后视力与平均用降眼压药物的比较超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察10原发性急性闭角型青光眼组术前术后视力与平均用降眼压药物的比 原发性慢性闭角型青光眼组 术后平均眼压11.641.25 mmHg 周围前房深度0.850.15 CK Primary chronic angle-closure glaucoma patientsPostoperative mean IOP was 11.641.25 mmHgMean limbic anterior chamber depth was 0.850.15 CK超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察11 原发性慢性闭角型青光眼组 Primary c 术后半年平均远视力为0.50.32眼术后用一种药物控制眼压可达21mmHg以下，其余不需用药物控制眼压即正常,平均用降眼压药0.07种 Mean visual acuity was 0.50.3 half a year after operation Only 2 eyes needs one drug each to control IOP below 21mmHg and the others were normal without any drug,mean drugs used to control IOP was 0.07 types超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察12 超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型原发性慢性闭角型青光眼组术前术后眼压与周围前房深度比较mmHgCK超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察13原发性慢性闭角型青光眼组术前术后眼压与周围前房深度比较mm原发性慢性闭角型青光眼组术前术后视力与平均用降眼压药物的比较超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察14原发性慢性闭角型青光眼组术前术后视力与平均用降眼压药物的比术后并发症术后1天：角膜轻度水肿13例（25）前房闪辉轻度39例（75），中度10例（19.2）术后1周：以上表现全部消失。所有术眼人工晶状体均在位，未出现偏位、夹持。Complications after operationThe day after operation：mild cornea edema 13 eyes（25）Tyn(+):39 eyes（75）mildly，10 eyes（19.2）seriously1 week after operation：all above were disappearedAll IOLs were stable in the centric area超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察15术后并发症术后1天：Complications after 五、讨论（DISCUSSION)超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察16五、讨论超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼前段空间狭窄眼前段空间狭窄晶状体较厚晶状体较厚且位置靠前且位置靠前晶状体虹膜膈前移晶状体虹膜膈前移虹膜背面与前虹膜背面与前囊紧密相贴囊紧密相贴瞳 孔 阻 滞虹膜根部被推向小梁网虹膜根部被推向小梁网前房变浅前房变浅房角变窄、闭合房角变窄、闭合眼 压 升 高超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察17眼前段空间狭窄晶状体较厚且位置靠前晶状体虹膜膈前移虹膜背面与白内障超声乳化手术白内障超声乳化手术晶状体有形成分吸出晶状体有形成分吸出提供虹膜后退的空间提供虹膜后退的空间降低眼压降低眼压术中前房压力升高术中前房压力升高机械性使房角开放机械性使房角开放超声作用超声作用减少房水分泌减少房水分泌解除瞳孔阻滞解除瞳孔阻滞超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察18白内障超声乳化手术晶状体有形成分吸出提供虹膜后退的空间降低眼经颞侧角巩膜缘切口优点将12点方位的角巩膜缘留出，为将来眼压控制不理想时再行滤过手术留有足够的空间 避免了经透明角膜切口导致的术后散光、角膜炎症反应重 等不良后果Advantages of temporal corneal limbus tunnels Reserve the 12 oclock corneal limbus tunnels for the filtering operations if needed in the futureAvoid some severe complications after operation through the cornea such as astigmatism and keratitis超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察19经颞侧角巩膜缘切口优点将12点方位的角巩膜缘留出，为将来眼压六、小 结（SUMMARY）颞侧角巩膜缘隧道切口超声乳化白内障吸除联合后房型折叠式人工晶状体植入术治疗合并白内障的急性或慢性闭角型青光眼可以 降低眼压 加深前房 提高视力 减少用药 Phacoemulsification with posterior chamber foldable intraocular lens implantation in treating angle-closure glaucoma with cataract through temporal corneal limbus tunnels decrease the IOP，increase the depth of anterior chamber and visual acuity and few drugs needed as well超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察20六、小 结（SUMMARY）颞侧角巩膜缘隧道切口谢 谢！超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青光眼合并白内障的临床观察21谢 谢！超声乳化白内障吸除折迭式人工晶状体植入治疗闭角型青