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首页> 外文期刊>Ophthalmology >Combined phacoemulsification and goniosynechialysis for uncontrolled chronic angle-closure glaucoma after acute angle-closure glaucoma.
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Combined phacoemulsification and goniosynechialysis for uncontrolled chronic angle-closure glaucoma after acute angle-closure glaucoma.

机译：白内障超声乳化联合goniosynechialysis治疗急性闭角型青光眼后无法控制的慢性闭角型青光眼。

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OBJECTIVE: To evaluate combined phacoemulsification, posterior chamber intraocular lens (PCIOL) implantation, and goniosynechialysis (phaco-GSL) prospectively in eyes with more than 180 degrees of peripheral anterior synechiae (PAS) and uncontrolled intraocular pressure (IOP) when performed within 6 months of an attack of acute angle-closure glaucoma (ACG). DESIGN: Prospective, noncontrolled clinical trial. PARTICIPANTS: Patients who had presented with acute ACG and had persistently uncontrolled IOP despite successful laser iridotomy for pupillary block and argon laser peripheral iridoplasty for continued appositional closure after iridotomy. INTERVENTION: After the completion of phacoemulsification and posterior chamber lens implantation, goniosynechialysis was performed in 52 eyes of 48 patients. MAIN OUTCOME MEASURES: Postoperative visual acuity, IOP, extent of PAS, and number of medications, if any, required for IOP control. RESULTS: Intraocular pressure was less than 20 mmHg in 47 eyes (90.4%) without medications; 4 were controlled with medications and 1 required filtration. Mean extent of PAS was reduced from 310 degrees to 60 degrees. Peripheral anterior synechiae formation or IOP elevation did not recur after 3 months after surgery up to 6 years. Eight patients achieved 20/20 visual acuity, while 44 patients had less than 20/20 visual acuity. No patient had worse visual acuity after surgery compared to before surgery. CONCLUSION: Phaco-GSL and PCIOL implantation is effective in reducing PAS and IOP and improving visual acuity in eyes with persistent chronic ACG when performed within 6 months after treatment for acute ACG.
机译：目的：评估在六个月内进行的周围前房性眼球粘连（PAS）超过180度且眼压不受控制的超过IO的眼中，前瞻性评估联合超声乳化，后房人工晶状体（PCIOL）植入和性腺软化（phaco-GSL）的情况急性闭角型青光眼（ACG）的发作。设计：前瞻性，非对照临床试验。研究对象：尽管虹膜切开术成功进行了激光虹膜切开术，而虹膜切开术后仍继续进行了闭锁手术，但仍患有急性ACG且IOP持续不受控制的患者。干预：超声乳化术和后房型晶状体植入术完成后，对48例患者的52眼进行了性腺电刺激。主要观察指标：术后视力，IOP，PAS范围以及控制IOP所需的药物数量（如有）。结果：47眼（90.4％）未使用药物时眼压低于20 mmHg。用药物控制4例，需要过滤1例。 PAS的平均范围从310度降低到60度。术后3个月（长达6年）未出现周围前粘连形成或IOP升高。 8位患者的视力达到20/20，而44位患者的视力低于20/20。与手术前相比，没有患者的手术后视力较差。结论：Phaco-GSL和PCIOL植入在急性ACG治疗后6个月内进行，可有效减少持续性ACG的眼睛的PAS和IOP，并提高视力。

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