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Extracapsular cataract extraction combined goniosynechialysis acute angle-closure glaucoma_2888

By Edith Stone,2014-10-30 17:37
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Extracapsular cataract extraction combined goniosynechialysis acute angle-closure glaucoma_2888

    Extracapsular cataract extraction combined goniosynechialysis acute angle-closure glaucoma

     Abstract [HTK observation of extracapsular cataract

    extraction with intraocular lens implantation

    goniosynechialysis treatment of cataract combined with acute

    angle-closure glaucoma, and postoperative anterior chamber angle change in the structure. Methods: extracapsular cataract extraction combined goniosynechialysis acute angle-closure

    glaucoma in 34 patients (37), their visual acuity before and

    after surgery, intraocular pressure, vision, central anterior chamber depth, anterior chamber angle morphology of controlled observation. Results: The 180? D after the follow-up, 34 cases

    (37) in 28 patients (30 eyes) compared with the preoperative

    visual acuity improved significantly. Preoperative anterior chamber depth (1.674 ? 0.478) mm, intraocular pressure

    (28.436 ? 3.325) mmHg, after 30? D anterior chamber depth (3.412 ? 0.169) mm, after 7? D intraocular pressure (13.983 ? 5.196) mmHg. After 30? D gonioscopy 34 cases (37) angle are open. 27 patients (28 eyes) after 6 months without narrowing the field of vision reexamination. Conclusion: The extracapsular cataract extraction combined goniosynechialysis such patients can reduce intraocular pressure, deepening the

    anterior chamber, open chamber angle and improve visual acuity.

     Key words extracapsular cataract extraction surgery goniosynechialysis angle-closure glaucoma

     AExtracapsular cataract extraction combined with

     [ABSTRACT] Objective: To investigate the clinical effect of extracapsular cataract extraction combined with goniosynechialysis in treatment of acute angle closure

glaucoma with cataract. Methods: Thirty four patients (37

    eyes) were subjected to this management. The anterior chamber

    depth, visual acuity , configuration of chamber anger, and intraocular pressure were determined. Results: After a mean postoperative follow up of 180 days, the best corrected

    visual acuity was improved in 28 cases (30 eyes). The mean anterior chamber depth was 1.674 ? 0.478 mm pre

    operatively and 3.412 ? 0.169 mm at post operative 30 days

    (t = 6.743, P <0.001). The intraocular pressure was decreased from a pre operative of 28.436 ? 3.325 mmHg to a

    postoperative 7 day of 13.983 ? 5.196 mmHg (t = 5.263, P

    <0.001). Angles of the anterior chamber were opened at post

    operative 30 days in all 34 patients. The visual field was not significantly changed in 15 patients at six months after operation. Conclusion: Extracapsular cataract extraction

    combined with lysis of the synechiae is safe and effective for acute angle closure glaucoma.

     [KEY WORDS] Extracapsular cataract extraction;

    Goniosynechialysis; Glaucoma; Angle closure glaucoma is a

    form of pathological intraocular pressure and visual

    impairment associated with the common blinding eye disease. Angle-closure glaucoma with shallow anterior chamber, narrow angle, and axial length and short features, which increase with age, its relative pupillary block caused by thickening of the lens, while the crystals can be removed to deepen the anterior chamber and open angle Adhesion yet , postoperative intraocular pressure in some patients obtain control, but the angle in patients with solid adhesion did not improve, intraocular pressure was still higher than normal levels. We have acute angle-closure glaucoma with cataract underwent

    cataract extraction and intraocular lens implantation goniosynechialysis will be the clinical indicators before and after surgery to compare the results now reported as follows.

     1 Data and methods

     1.1 General Information option from January 2003 to December 2005 at the Shandong University Qilu Hospital, diagnosed with acute angle-closure glaucoma with cataract

    patients 34 cases (37), of which 11 males (13), female 23

    cases ( 24), 57 76 years, an average of 64 years of age; lens cortical opacity in 23 cases (26), lens nuclear opacity in 6 cases (6 eyes), posterior subcapsular cortical opacity 5 cases

(5 eyes). Surgery before the surgery eye (visual acuity "0.3)

    for routine vision, intraocular pressure, central anterior chamber depth, gonioscopy line perimetry. The higher preoperative IOP, intraocular pressure lowering treatment given to drug. Depth and degree of anterior chamber intraocular lens-specific A measurement applications

    ophthalmic ultrasound measured (the United States, STORZ COMPUSCAN LT), were continuously measured 16 times, the data processed and displayed automatically by a computer print, take the mean registration; vision using automatic perimetry

    (Chongqing, Hong-ASP6000-type) measurements.

     1.2 All surgical operations by a physician with the completion of peribulbar anesthesia. The top of the limbus, after 1? Mm president of 6? Mm scleral tunnel incision in the corner of puncture into the anterior chamber, anterior chamber injection of viscoelastic agents. Under direct vision with viscoelastic injection needle along the angle down slowly into the viscoelastic agent, a continuous injection of addition to the top of the 270 ? angle than would be apparent iris root

    pressure to subside, and use the iris, under gentle pressure bulge Restorer to separate the root of the iris adhesion angle. Followed by continuous curvilinear capsulorhexis, the water separating nuclear and cortex, the nuclear suspension in

    the anterior chamber, his hands France birth to a child of nuclear or nuclear fish out key ring after implantation chamber 5.5? Mm diameter PMMA intraocular lens in the capsular bag. Surgery goes well, without intraoperative posterior

    capsule rupture. There are four cases when the anterior chamber angle in the separation of bleeding, hemostasis after injection of viscoelastic agents.

     1.3 Routine postoperative care given corticosteroid and non-steroidal anti-inflammatory drugs and eye-dilation agents,

    the former three days of oral prednisone and acetazolamide. 1,7,15,30,180 days after the first routine examination, including visual acuity, slit lamp, and intraocular pressure; Article 30,60,180 days with routine examination and gonioscopy; after 6 months follow-vision.

     1.4 Statistical analysis using SAS8.0 statistical software, paired t test.

     2 Results

     2.1 postoperative day 1 IOP of 34 cases (37) The average intraocular pressure (13.896 ? 4.045) mmHg, and preoperative

    mean intraocular pressure (28.436 ? 3.325) mmHg, the

    difference was statistically significant (t = 5.263, P "0.001); the average intraocular pressure after the first 7 days (13.983 ? 5.196) mmHg, the first 180 days (14.562 ?

    3.124) mmHg. Are in normal range.

     2.2 The anterior chamber depth after the first 30 days, the average anterior chamber depth (3.412 ? 0.169) mm and the

    mean preoperative anterior chamber depth (1.674 ? 0.478) mm,

    the difference was statistically significant (t = 6.743, P <0.001).

     2.3 The vision in table 1. Preoperative visual acuity of light perception to 0.5, postoperative best corrected visual acuity 0.04 1.0. 35 compared with the preoperative visual