摘要目的 评价Volk前房角镜在超声乳化联合前房角分离术中的应用效果.方法 原发性闭角型青光眼(PACG)伴白内障行超声乳化联合前房角分离术中应用Volk前房角镜440例(558眼),分析其临床资料.对手术前后的视力、眼压、前房角状态、中央前房深度、并发症等进行对照观察.结果 术后97.67％的眼视力较术前提高.术前用药后眼压(25.36±2.79) mmHg,术后降至(13.02±3.86) mmHg,(1 mmHg =0.133 kPa),差异有统计学意义(t=12.66,P＜0.05).术前前房角关闭的象限术后有不同程度的开放,原先粘连的前房角已分离.术前平均中央前房深度为(2.11±0.53)mm,术后增加至(3.02 ±0.44) mm,差异有统计学意义(t=11.58,P＜0.05).术中术后并发症:9眼(1.6％)术中发生后囊破裂,但均未发生晶状体核脱落于玻璃体腔等严重并发症.72眼(12.9％)术后轻度角膜水肿,经保守治疗均恢复正常.未出现角膜内皮失代偿或视网膜脱离等严重并发症.结论 对于PACG伴白内障,且前房角关闭＜180°的患者,超声乳化联合Volk前房角镜下前房角分离术能够有效打开关闭的前房角,加深前房,控制眼压,手术针对性强,前房角分离效果观察及时,而且并发症少.

abstractsObjective To evaluate the clinical efficacy of Volk gonioscope in phacoemulsification combined with goniosynechialysis.Methods Five hundreds and fifty-eight eyes of 440 patients with primary angle-closure glaucoma and cataract underwent the operation of phacoemulsification combind with goniosynechialysis under Volk gonioscope in our hospital.The vision,intraocular pressure(IOP),angle of anterior chamber,depths of the central anterior chamber and complications were observed before and after the surgery.Results The visual acuity was improved compared with that before surgery in 97.67％ eyes.The postoperative mean IOP was (13.02 ±3.86) mmHg,while the preoperative IOP after using drugs was (25.36± 2.79)mmHg,and the difference was statistically significant (t =12.66,P ＜0.05).Preoperative closured chamber angle opened after the surgery in different degrees.The preoperative mean central anterior chamber depth was (2.11 ± 0.53) mm,while the postoperative depth increased to (3.02 ± 0.44) mm,and the difference between them was statistically significant (t =11.58,P ＜ 0.05).The posterior capsule of lens ruptured during the surgery in 9 eyes but without lens fragments falling into vitreous.Mild corneal edema happened in 72 eyes,and returned to normal after conservative treatment.There was no serious complication such as corneal endothelial decompensation or retinal detachment.Conclusion The combined procedure of phacoemulsification combined with goniosynechialysis under Volk gonioscope is safe and effective for patients who have PACG and cataract with closed angle less than 180°