Combined phacoemulsification, intraocular lens implantation and trabeculectomy for chronic angle closure glaucoma

被引:18
作者
Tow S.L.C. [1 ]
Aung T. [1 ]
Oen F.T.S. [1 ]
Seah S.K.L. [1 ]
机构
[1] Singapore National Eye Centre, Singapore 168751
关键词
Phacoemulsification; Primary angle closure glaucoma; Trabeculectomy;
D O I
10.1023/A:1025478923950
中图分类号
学科分类号
摘要
Purpose: To investigate the results of combined phacoemulsification, intraocular lens implantation and trabeculectomy in Asian patients with chronic angle closure glaucoma (CACG). Methods: This was a retrospective non-comparative case series of 55 consecutive patients (57 eyes) who underwent phacoemulsification, posterior chamber intraocular lens implantation and trabeculectomy for CACG at the Singapore National Eye Centre between 1997-1998. The surgical outcome was assessed in terms of intraocular pressure (IOP), the incidence of complications and the visual acuity at last follow-up. Success was defined as final IOP ≤ 21 mmHg without medication and qualified success as final IOP ≤ 21 mmHg with medication. Patients with final IOP > 21 mmHg who required further glaucoma surgery, lost light perception or became pthisical, were classified as failures. The eyes were further categorized into two groups according to whether single-site or separate-site surgery was performed. The outcome was also compared among eyes in which per-operative antimetabolites were applied to the trabeculectomy site and those without antimetabolites. Results: The mean follow up was 22.0 ± 5.6 months (mean ± SD). Success was achieved in 46 (81%) eyes, qualified success in 10 (17%) eyes, and failure in 1 (2%) eye. In terms of IOP outcome, the success rate was similar in the two surgical groups (single-site or separate-site). There was no significant difference in IOP outcome among eyes in which per-operative antimetabolites were used and eyes with no per-operative antimetabolites use. Forty-one eyes (72%) had 6/12 or better vision. There were no cases of intraoperative complications and the incidence of postoperative complications was low. Conclusions: Combined phacoemulsification, intraocular lens implantation and trabeculectomy is associated with good intraocular pressure control and visual outcome in patients with CACG.
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页码:283 / 289
页数:6
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共 31 条
[1]  
Thylefors B., Negrel A.D., Pararajasegaram R., Dedzie K.Y., Global data on blindness, Bull WHO, 73, pp. 115-121, (1995)
[2]  
Congdon N., Wang F., Tielsch J.M., Issues in the Epidemiology and population based screening of primary angle closure glaucoma, Surv Ophthalmol, 36, pp. 411-423, (1992)
[3]  
Quigley H.A., Number of people with glaucoma worldwide, Br J Ophthalmol, 80, pp. 389-393, (1996)
[4]  
Foster P.J., Baasanhu J., Alsbirk P.H., Et al., Glaucoma in Mongolia - A population-based survey in Hovsgol Province, Northern Mongolia, Arch Ophthalmol, 114, pp. 1235-1241, (1996)
[5]  
Foster P.J., Oen F.T., Machin D., Et al., The prevalence of glaucoma in Chinese residents of Singapore: A cross-sectional population survey of the Tanjong Pagar district, Arch Ophthalmol, 118, pp. 1105-1111, (2000)
[6]  
Ritch R., Lowe R.F., Angle closure glaucoma, The Glaucomas, 2nd edn, (1996)
[7]  
Wang N., Wu Z., Liu H., Mechanism and etiology of primary chronic angle closure glaucoma, Yen KO Hsueh Pao, 10, pp. 186-192, (1994)
[8]  
Kim Y.Y., Jung H.R., Clarifying the nomenclature for primary angle-closure glaucoma, Surv Ophthalmol, 42, pp. 125-136, (1997)
[9]  
Gelber E.C., Anderson D.R., Surgical decisions in chronic angle-closure glaucoma, Arch Ophthalmol, 94, pp. 1481-1484, (1976)
[10]  
Playfair T.J., Watson P.G., Management of chronic or intermittent primary angle-closure glaucoma: A long-term follow-up of the results of peripheral iridectomy used as an initial procedure, Br J Ophthalmol, 63, pp. 23-28, (1979)