陆融 王杨宁致

摘 要 目的：分析单纯性晶状体摘除对老年患者原发性闭角型青光眼的治疗效果。方法：将50岁以上原发性闭角型青光眼患者51例（63眼）作为研究对象，所有患者均以超声生物显微镜（UBM）检查确认房角关闭<180°，行晶状体超声乳化摘除术+人工晶状体植入术，观察术后1月、3月、6月的眼压及视力情况。结果：患者术后患眼眼压控制较好，且60岁以上的患者术后视力的提高较50～60岁患者更为显著。结论：单纯性晶状体摘除对房角关闭<180°的老年患者原发性闭角型青光眼眼压控制效果良好，可提高部分患眼的术后视力，是一种可以考虑的术式。

关键词 晶状体 原发性闭角型青光眼 眼压

中圖分类号：R779.6； R775.2 文献标志码：B 文章编号：1006-1533（2021）23-0071-03

Effect of simple lens extraction on primary angle-closure glaucoma in elderly patients

LU Rong， WANG Yangningzhi

（Department of Ophthalmology， Wuxi People’s Hospital affiliated to Nanjing Medical University， Wuxi 214023， China）

ABSTRACT Objective： To analyze the effect of simple lens extraction on primary angle-closure glaucoma in elderly patients. Methods： Fifty-one patients over 50 years old （sixty-three eyes） with primary angle-closure glaucoma were selected as subjects. All patients were checked by ultrasound biomicroscope （UBM） to confirm that the angle of the chamber was closed<180° and underwent phacoemulsification and intraocular lens implantation. The intraocular pressure and visual acuity were observed 1 month， 3 months and 6 months after operation. Results： The postoperative intraocular pressure of the patients was controlled well， and the improvement of postoperative visual acuity was more significant in the patients over sixty years old than 50-60 years old. Conclusion： Simple lens extraction is an effective method for controlling IOP in primary angle-closure glaucoma in elderly patients with angle closure less than 180 degrees， can improve the postoperative visual acuity of some affected eyes and is a surgical procedure that can be considered.

KEY WORDS lens； primary angle-closure glaucoma； intraocular pressure

原发性闭角型青光眼的眼前节较正常眼及原发性开角型青光眼狭窄，其中急性原发性闭角型青光眼有更厚的晶状体且晶状体位置更加靠前[1]。晶状体随着年龄不断增长，这必将引起其厚度增加，其相对位置更加向前，正常眼中这种变化不一定导致房角关闭，但在已有眼前段狭窄的高危房角患眼中，晶状体的膨胀将大大加重房角关闭的程度[2-3]。在老年闭角型青光眼患眼中，晶状体膨胀且变厚是引起眼压升高的重要因素[4-5]。

中华医学会眼科学分会青光眼学组提出，对于房角关闭<180°的青光眼患眼，青光眼合并白内障的手术方式可行单纯的白内障手术[6]。本文对50岁以上闭角型青光眼，并以UBM检查确认房角关闭<180°的患眼行晶状体超声乳化摘除术+人工晶状体植入术，观察术后1月、3月、6月的眼压及视力情况。……