青光眼病患施行白內障摘除術之研究

Studies on the Cataract Extraction in Glaucoma Patients

謝瑞玟(Jui-Wen Hsieh) ； 楊熹明(Hsi-Ming Yang) ； 陳立仁(Lee-Jen Chen)

《中華民國眼科醫學會會刊》 30卷4期 (1991/12) Pp. 39-46

https://doi.org/10.30048/ACTASOS.199112.0131

摘要

作者收集自民國77年1月至79年6月之間，於馬偕醫院眼科，青光眼合併白內障之患者接受白內障摘除手術，計29位35眼，男性11位15眼，女性18位20眼，平均年齡為66.5歲，術後追蹤最少3個月，最長30個月，平約為11.3個月。其中隅角閉鎖性青光眼24眼，隅角開放性青光眼6眼，繼發性青光眼5眼。術前曾接受青光眼外科療法者29眼，藥物療法者6眼。白內障手術術式以囊外摘除合併後房人工水晶體植入27眼為最多，其中有6眼作角膜切口中。5眼作合併青光眼濾過術及白內障摘除術式。術前眼壓控制大多良好，高於21mmHg者有5眼，術前視力皆低於0.2以下。除一例類固醇引起眼壓升高外，97.1%術後眼壓皆能控制良好。術後仍需使用藥物控制眼壓者自術前之28眼減至9眼。如需點藥者，藥物種類亦可減少。視力在術後皆有進步，45.7%的病例回復至0.3以上，若扣除視神經萎縮之7眼，則達57.1%。術式之選擇為依病患之情形而決定，一般而言都能獲得良好之結果。

並列摘要

The safety and efficacy of cataract extraction on patients with coexisting glaucoma were evaluated retrospectively in 35 consecutive operations from Jan. 1988 to June 1990. Eleven males (15 eyes) and 18 females (20 eyes) with average age of 66.5 years old were included. Post-operative follow-up period was 3 months to 30 months (average 11.3 months). The types of glaucoma were angle closure glaucoma 24 eyes, open angle glaucoma 6 eyes, secondary glaucoma 5 eyes. There were 29 eyes received surgical treatment for glaucoma before cataract operation while only 6 eyes were controlled by medication.
The cataract were extracted mainly by ECCE with PCIOL implantation (27 eyes). Six eyes were done by corneal incisions to preserve the bleb. Combined cataract extraction and trabeculectomy were performed in 5 eyes. The pre-operative IOP was well controlled in most cases while there were only 5 eyes with IOP over 21 mmHg. Post-operatively, IOP was well controlled in 97.1% of cases with the exception of one eye which was due to steroid response. Antiglaucoma medications were indicated in 28 eyes before operation while only 9 eyes were indicated postoperatively. The kinds of antiglaucoma medication were also reduced. The postoperative visual accuity was improved, that was 45.7% of eyes with visual accuity over 0.3. It would be 57.1% if 7 eyes with optic nerve atrophy were excluded.

並列關鍵字

cataract extraction ； glaucoma ； intraocular pressure ； intraocular lens